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Total thyroidectomy en bloc or not? prospective, randomized clinical trial: Cerrahpasa experience

  • Clinical Study
  • Published:
Hellenic Journal of Surgery

Abstract

Aim-Background

While significant changes in the last century have enabled safe and effective total thyroidectomy, the utility and reliability of techniques for patients with benign diseases is debatable. The purpose of this study was to compare the complication rates of division of the isthmus vs. non-division in thyroid surgery performed for bilateral multinodular goiter by experienced endocrine surgeons. To the best of our knowledge, no such study has been published in the literature to date.

Methods

This prospective study includes 60 consecutive serial patients who underwent total thyroidectomy. Patients were randomly assigned to a thyroidectomy technique by the arbitrary draw from a bag of paper tags marked as ‘U’ (thyroidectomy without dividing the isthmus) classified as Group 1 or ‘D’ (thyroidectomy by dividing the isthmus) as Group 2. Patients in Group 1 (n=30) had a total thyroidectomy without dividing the isthmus (en bloc), patients in Group 2 (n=30) had total thyroidectomy by dividing the isthmus.

Results

Postoperative serum mean calcium and parathyroid hormone (PTH) levels, operation period, visual analogue pain score and recurrent laryngeal nerve paralysis did not differ between the groups. Permanent hypocalcaemia and permanent recurrent laryngeal nerve paralysis were not observed in either group, but total morbidity in Group 1 was higher (p=0.038). Postoperative PTH levels were significantly lower than preoperative PTH levels in both groups; (respectively, p=0.007, p=0.011). No surgical mortality was recorded.

Conclusion

Thyroidectomy without dividing the isthmus can be qualified as a safe and applicable surgical method.

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Authors and Affiliations

  1. Cerrahpasa Medical Faculty, Department of General Surgery, Cerrahpasa Tip Fakultesi Genel Cerrahi AD, Istanbul University, 34098, Fatih/Istanbul, Turkey

    Hamit Ahmet Kabuli, Serkan Teksoz, Akif Enes Arikan, Yusuf Bukey, Murat Ozcan & Ates Ozyegin

  2. Cerrahpasa Tip Fakultesi Genel Cerrahi AD, 34098, Fatih/Istanbul, Turkey

    Serkan Teksoz

Authors
  1. Hamit Ahmet Kabuli
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  2. Serkan Teksoz
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  3. Akif Enes Arikan
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  4. Yusuf Bukey
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  5. Murat Ozcan
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  6. Ates Ozyegin
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Corresponding author

Correspondence to Serkan Teksoz.

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Kabuli, H.A., Teksoz, S., Arikan, A.E. et al. Total thyroidectomy en bloc or not? prospective, randomized clinical trial: Cerrahpasa experience. Hellenic J Surg 86, 5–9 (2014). https://doi.org/10.1007/s13126-014-0086-0

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  • DOI: https://doi.org/10.1007/s13126-014-0086-0

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