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Abstract The extent of thyroidectomy in benign thyroid disease is still a matter of debate and shows a large spectrum of management strategies, from nodulectomy to total thyroidectomy. The aim of all these procedures is to perform the most effective treatment with the less complications, without the incidence of recurrence and without the need for secondary surgical intervention which will be very difficult and hazardous due to disturbed anatomy and adhesions with a high incidence of RLNI and/or hypoparathyroidism. This work aimed to compare the incidence of complications and surgical outcome in patients operated upon for benign goitre disease applying both modalities of surgery i.e. total and subtotal thyroidectomy discussing different opinions with and against applying total or subtotal thyroidectomy in MNG & Grave’s disease. This study points out to the most important complication of subtotal thyroidectomy which is recurrence; a complication which is absent in case of Total thyroidectomy. Recurrence takes the patient to the risk of secondary management either by radioactive Iodine or secondary surgical intervention which will be very difficult and hazardous due to disturbed anatomy and adhesions increasing the risk of RLNI and/or hypoparathyroidism. Our work comprised 60 patients with benign goitre disease who were candidates for surgical interference. These Patients were presented to us during the period of this study manifested either by swelling in the neck or thyrotoxic manifestations or both. 30 patients who were subjected to subtotal thyroidectomy during the past three years as a treatment for MNG or Grave’s disease. 30 Patients who had recently underwent total thyroidectomy as a primary treatment for MNG and Grave’s disease. Postoperative follow up for these two groups of patients was done to detect any complications, especially RLNI & hypoparathyroidism and only 1 case was reported to have RLNI which was transient and 2 presented by postoperative hypocalcemia. The study also pointed out that there is an obvious decrease in the rate of complications associated with total thyroidectomy especially with increasing experience and refinement of surgical technique. At the end we discuss different opinions and studies that are most recent in the international medical field with total throidectomy in cases of MNG and Graves’ disease with pointing out to the few opinions against total thyroidectomy in cases of MNG and Graves’ disease which still persists. |