Thyroxine prophylaxis after bilateral subtotal thyroidectomy for multinodular goiter

In this study, we investigated the value of thyroxine administration to pre vent recurrence after bilateral subtotal thyroidectomy for multinodular goi ter. Patients that had benign multinodular goiter were operated on with the same surgical principles: ligation of both superior and inferior thyroid a rteries on both sides, bilateral subtotal resection of thyroid gland includ ing all visible nodules. On the 3rd postoperative day, the patients were di vided into two groups: with 100 microgram 1-thyroxine daily (Thyroxine grou p) or no therapy (Control group). No recurrences were encountered among 40 patients followed up for 6 months and 20 patients for at least one year. Un e patient in the control group developed manifest hypothyroidism (5.3%). Th e mean TSH level of the control group was significantly higher than that of thyroxine group at 1st, 2nd, 3rd, 4th, 5th, 6th, and 12th months. At the e nd of the first year, the mean TSH level of the control group was four time s that of the normal. On the other hand, the mean TSH level of the thyroxin e group was within normal limits but not suppressed. In conclusion, we foun d that the pituitary-thyroid axis did not become normal spontaneously one y ear after thyroidectomy. Therefore, postoperative thyroxine administration seems to be of value, especially in endemic regions like Turkey.