Background: Even though Total Thyroidectomy is the treatment of choice for Multinodular goiter ,thyroid cancer, many surgeon deter  to do total  thyroidectomy for benign thyroid diseases because of risk associated with total thyroidectomy. We  prospectively  analyzed 150 total thyroidectomies  done for various benign thyroid diseases .We analyzed all the parameters to assess whether our  result support total thyroidectomy as safe and optimal procedure for treating  benign thyroid diseases

Methods: A total of 150 patients underwent total thyroidectomy between 2011-2013.We excluded patients with thyroid cancer and repeat surgery. We evaluated the indication for surgery, postoperative complication rates and local recurrence rates.

Results: 123 patients were diagnosed as euthyroidmultinodular goiter and 20 were toxic multinodular goiter and 7 were diagnosed as Graves’disease. Both temporary and permanent recurrent laryngeal nerve palsy is 0%.Temporary hypocalcaemia occurred in 15(10%) patients and there was no permanent hypoparathyroidism. Postoperative mortality is 0%

Conclusion: Total thyroidectomy is a safe and optimal procedure for benign thyroid diseases when it is indicated .Postoperative complication is similar to subtotal thyroidectomy. Total thyroidectomy avoids recurrence and malignancy risk

Keywords: Hypoparathyroidism, multinodular goiter, recurrent laryngeal nerve, Total thyroidectomy.

1. Gough IR, Wilkinson D. Total thyroidectomy for management of thyroid disease. World J Surg 2000;24:
2. Bron LP, O’Brien CJ. Total thyroidectomy for clinically benign disease of the thyroid gland. Br J Surg 2004; 91:569-74.962-5.
3. Friguglietti CU, Lin CS, Kulcsar MA. Total thyroidectomy for benign thyroid disease. Laryngoscope 2003;113:1820-6.
4. Phillips AW, Fenwick JD, Mallick UK, et al. The impact of clinicalguidelines on surgical management in patients with thyroid cancer. ClinOncol (R CollRadiol) 2003;15:485-9.
5. Beenken S, Roye D, Weiss H, et al. Extend of surgery for intermediate -risk well-differentiated thyroid cancer. Am J Surg 2000;179:51-6.
6. Kebebew E, Duh QY, Clark OH. Total thyroidectomy or thyroidlobectomy in patients with low-risk differentiated thyroid cancer: surgical decision analysis of a controversy using a mathematical model. World J Surg 2000;24:1295-302.
7. Weber KJ, Solorzano CC, Lee JK, et al. Thyroidectomy remains an effective treatment option for Graves disease. Am J Surg 2006; 191:400-5.
8. Lal G, Ituarte P, Kebebew E, et al. Should total thyroidectomy become the preferred procedure for surgical management of Graves disease? Thyroid 2005; 15:569-74.
9. Ku CF, Lo CY, Chan WF, et al. Total thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves disease. ANZ J Surg 2005;75:528-31.
10. Pisanu A, Montisci A, CoisA, et al. Surgical indications for toxic multi nodulargoitre. ChirItal 2005;57:597-606.
11. Marchesi M, Biffoni M, Tartaglia F, et al. Total versus subtotal thyroidectomy in the management of multinodular goiter. IntSurg 1998;83:202-4.
12. Hegedus L, Bonnema SJ, Bennedbaek FN. Management of simple nodular goiter: current status and future perspectives. Endocr Rev 2003;24:102-32.
13. Khadra M, Delbridge L, Reeve TS, et al. Total thyroidectomy: its role in management of thyroid disease. Aust N Z J Surg 1992;62:91-5.
14. Harness JK, Fung L, Thompson NW, et al. Total thyroidectomy:complications and technique. World J Surg 1986;10:781-6.
15. Erbil Y, Barbaros U, Issever H, et al: Predictive factors for recurrent laryngeal nerve palsy and hypoparathyroidism after thyroid surgery ClinOtolaryngol 2007, 32:32–37.
16. Perzik S. The place of total thyroidectomy in the management of 909 patients with thyroid disease. Am J Surg 1976;132:480-3.
17. Reeve TS, Delbridge L, Cohen A, et al. Total thyroidectomy. The preferred option for multinodular goiter. Ann Surg 1987;206:782-6.
18. Liu Q, Djuricin G, Prinz RA. Total thyroidectomy for benign thyroid disease. Surgery 1998;123:2-7.26
19. Younes N, Robinson B, Delbridge L. The aetiology, investigationand management of surgical disorders of the thyroid gland. Aust N Z J Surg 1996;66:481-90.
20. Beahrs OH, Vandertoll DJ. Complications of secondary thyroidectomy. Surg Gynecol Obstet 1963;117:535-9.
21. Zambudio AR, Rodriguez J, Riquelme J, et al. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann Surg 2004;240:18-25.
22. Reeve TS, Delbridge L, Brady P, et al. Secondary thyroidectomy: a twenty-year experience. World J Surg 1988;12:449-53.

Dr. M.P. Kumaran

Department of Endocrine Surgery, Madras Medical College, Chennai