الفهرس 
Embryology and anatomy of theOnly 14 pages are availabe for public view
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Abstract
Introduction: Multinodular goiter is a common clinical problem that usually develops during the late stage of goiter. Although it is usually benign and asymptomatic in nature, multinodular goiter may predispose the patient to compressive symptoms, develops autonomous functioning nodules, or form suspicious nodules. The clinical treatment of goiter depends on the extent of enlargement, signs and symptoms, and potential underlying causes. Thyroidectomy methods range from nodulectomy to total thyroidectomy (TT) in benign thyroid disorders. TT and bilateral subtotal thyroidectomy (BST) are the most commonly preferred methods by surgeons for MNG. The selected surgical method for thyroid disease should aim to eradicate the disease as well as to minimize postoperative complications. Many areas of surgery continually try to balance the benefits of extensive resection in terms of palliation and cure and the increased potential for complications associated with more radical procedures.
Aim of the work : To compare between two surgical techniques of treatment of multinodular goiter, total thyroidectomy and subtotal thyroidectomy as regard advantage and disadvantage of each of them.
Materials and Methods : systematic review meta analysis study.
Results: relative risk ratio of total over subtotal thyroidecdtomy is transient RLN palsy 1.828; permanent RLN palsy 1.31; transient hypoparathyroidism 2.389; permanent hypoparathyroidism 1.48, incidental thyroid carcinoma 1.691, recurrence 0.013.
This study is mainly concerned with comparing two surgical techniques of thyroidectomy in treatment of multinodular goiter, total thyroidectomy and subtotal thyroidectomy as regard postoperative complications and recurrence via a meta-analysis which showed that the advantages of total thyroidectomy include adequate eradication of the disease, prevention of recurrent goiter and avoidance of the need for completion surgery in case of occult malignancy, but it is associated with higher morbidity ( postoperative thyroidectomy complications: RLN palsy and hypoparathyroidism ) and the need for lifelong replacement therapy ( L-thyroxin supplementation).