Total thyroidectomy for benign thyroid disorders in an endemic region

Total thyroidectomy is increasingly being accepted as a treatment of choice for differentiated thyroid cancer. However, because of presumed increased morbidity associated with this procedure, it is still not considered a viab le option for management of benign thyroid disorders. To assess the safety and efficacy of total thyroidectomy for management of benign thyroid disord ers, we analyzed our data from 127 total thyroidectomies performed for beni gn thyroid disorders. Demographic details, biochemical findings, indication s for operation, specimen weight, and complications were noted. Among these patients, 52 had a toxic goiter and 75 had a nontoxic goiter. The mean dur ation of the goiters being present was 6.08 +/- 6.06 years (0.9-26.0 years) , and the mean weight of the specimens was 136.88 +/- 120.68 g. The inciden ce of occult malignancy was 6.3% (n = 8), and those of permanent hypothyroi dism and permanent recurrent laryngeal nerve palsy were 1.6% and 0.8%, resp ectively. Total thyroidectomy should be considered a treatment of choice fo r multinodular goiter and Graves' disease in a setting of palpable nodule(s ) or ophthalmopathy (or both). It is particularly relevant in endemic regio ns where patients present with a long-standing, large nodular goiter with v irtually no normal thyroid tissue. Reoperation for recurrent goiter in such a setting mould be fraught with distressing complications.