Methods of surgical treatment of multinodular goiter in patients living in an iodine-deficient region

Magomedov М. М., Osmanov О. М.

The results of surgical treatment of 548 patients with multinodular goiter were analyzed over a ten-year period. The middle age of the examined patients was 50.3+11.6 years, 80 % of women. The study objective is to determine the risk factors for complications and their occurrence post various methods of thyroidectomy in patients with multinodular goiter. The patients were divided into two groups. The patients operated in 2009–2015 (308 patients in total) were assigned to the first group with subtotal thyroidectomy. The second group included 240 patients who underwent total thyroidectomy in 2016–2019. Among 308 patients of the first group, 85 patients (27.5 %) had relapse and 139 patients (41.9 %) had hypothyroidism. When comparing the surgical procedures such as subtotal thyroidectomy and total thyroidectomy, statistical significance was registered. Transient hypoparathyroidism was diagnosed much more often in patients post total thyroidectomy vs patients post subtotal thyroidectomy. The key factors affecting the recurrence of benign thyroid nodule are: young age, iodine deficiency in the region, bilateral multinodular goiter and insufficient surgical intervention. If we consider the methods of surgical treatment of multinodular goiter with regard to the risk of complications, then total thyroidectomy is most effective in comparison with subtotal thyroidectomy.

Keywords:multinodular goiter, thyroidectomy, subtotal thyroidectomy, hemithyroidectomy, thyroid gland.