الفهرس 
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Abstract
Hashimoto’s thyroiditis (HT) is an organ –specific autoimmune disease characterized by production of antibodies such as anti-thyroperoxidase (TPOAb), which leads to destruction of the thyroid gland and a decrease in normal thyroid function. Typically, Hashimoto’s thyroiditis is treated medically; however, thyroidectomy may occasionally be necessary.
Hashimoto’s thyroiditis（HT) is usually managed by levothyroxine（L-T4） administration, which can reduce the thyroid volume and supplement the lack of hormone. However, we sometimes face a goiter that has not decrease on size in response to L-T4 therapy. These goiters continue to produce symptoms of compression and an unpleasant appearance. When a patient exhibits symptoms or when there is a possibility of neoplastic degeneration, a thyroidectomy is performed; nevertheless, the surgery might be challenging because of the dense inflammatory process surrounding the thyroid gland. We hyposized that patients with HT might experience more complications after thyroidectomy. Thyroiditis may raise the risk of surgical complications and make thyroid dissection more challenging.
The goals of this study are evaluation and determination of the technical difficulties of patients with Hashimoto’s thyroiditis who underwent total thyroidectomy. The intraoperative parameters included the operative time and blood loss.
This study included 46 patients with thyroid disease. The patients were divided into two groups. group A was formed from 25 patients with radiological and laboratory proven HT which was confirmed by post-operative pathology. group B consisted of 21 patients with non-malignant types of goiters. Thirty eight patients were female and eight were male, and their ages ranged between 18-72 years. All patients underwent Total thyroidectomy.
Both groups showed female predominance, and the age distribution was similar in both groups.
The operativ