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| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2013;6(10):922-929
Original Artice
What do we leave behind after neartotal and subtotal thyroidectomy: just the tissue
or the disease?
Rojbin Karakoyun, Nurullah Bülbüller, Savaş Koçak, Mani Habibi, Umut Gündüz, Bekir Erol, Osman Öner, Arif Aslaner, Dinç Sürer,
Şükrü Özdemir, Hakan Gülkesen
Department of Surgery, Antalya Training and Research Hospital, Antalya, Turkey; Division of Endocrine Surgery, Department of General
Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey; Department of Radiology, Antalya Training and Research Hospital,
Antalya, Turkey; Department of Pathology, Antalya Training and Research Hospital, Antalya, Turkey; Department of Statistics, Faculty of
Medicine, Akdeniz university, Antalya, Turkey
Received September 20, 2013; Accepted October 5, 2013; Epub October 25, 2013; Published October 30, 2013
Abstract: Selection of multinodular goiter (MNG) surgery procedure is stilll under discussion. Subtotal thyroidectomy (STT) and
neartotal thyroidectomy (NTT) are preferred surgical procedures. However, it is uncertain whether the remnant tissue contains
pathological findings or not after these procedures. We aimed to evaluate and comparison the pathologic findings in remnant tissue
after NTT and STT. Thyroid tissue samples of 50 patients who underwent TT for MNG disease between January 2010 and August 2011
in our clinic were evaluated. Before the dissection of the thyroid tissue subtotal and neartotal margins were marked in both right and left
lobes. After the resection of the specimen, the tissue was excised from the subtotal and neartotal margin marked during the surgery.
The pathologic findings of the main tissue, the residual subtotal and neartotal tissues were evaluated and compared. All patients were
followed-up 1 year. 43 (86%) females and 7 (14%) males with an average age of 50.5 (23-77) were included in the study. Incidental
papillary thyroid cancer was detected in 5 patients (10%). Pathologic findings were present in 31 patients (62%) of subtotal residual
tissue and 28 of the patients (56%) of neartotal residual tissue. Papillary microcarcinoma was detected in 3 (9.7%) of subtotal residual
tissues and 2 (7.1%) of neartotal residual tissues. There is no significant difference between subtotal and neartotal tissues in terms of
existence of pathological findings (p>0.05). There is no significant difference between the neartotal and subtotal residual tissues
contralateral of dominant nodule (p>0.05). 2 of the patients (4%) had temporary hypocalcemia, 1 patient (2%) had seroma and 1 patient
(2%) had recurrent laryngeal nerve injury. There are high rates of microscopic pathological findings on residual tissues both after STT
and NTT. The neartotal and subtotal residual tissues contralateral to the large nodule also had high levels of pathologic findings.
(IJCEM1309011).
Keywords: Total thyroidectomy, subtotal thyroidectomy, neartotal thyroidectomy, residual tissue, multinodular goiter
Address correspondence to: Dr. Rojbin Karakoyun, Department of General Surgery, Antalya Training and Research Hospital, Varlık
Mh, 07050 Muratpasa, Antalya, Turkey. Tel: +90 5059127841; Fax: +90 242 249 44 62; E-mail: drrojbin@hotmail.com
Original Artice
What do we leave behind after neartotal and subtotal thyroidectomy: just the tissue
or the disease?
Rojbin Karakoyun, Nurullah Bülbüller, Savaş Koçak, Mani Habibi, Umut Gündüz, Bekir Erol, Osman Öner, Arif Aslaner, Dinç Sürer,
Şükrü Özdemir, Hakan Gülkesen
Department of Surgery, Antalya Training and Research Hospital, Antalya, Turkey; Division of Endocrine Surgery, Department of General
Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey; Department of Radiology, Antalya Training and Research Hospital,
Antalya, Turkey; Department of Pathology, Antalya Training and Research Hospital, Antalya, Turkey; Department of Statistics, Faculty of
Medicine, Akdeniz university, Antalya, Turkey
Received September 20, 2013; Accepted October 5, 2013; Epub October 25, 2013; Published October 30, 2013
Abstract: Selection of multinodular goiter (MNG) surgery procedure is stilll under discussion. Subtotal thyroidectomy (STT) and
neartotal thyroidectomy (NTT) are preferred surgical procedures. However, it is uncertain whether the remnant tissue contains
pathological findings or not after these procedures. We aimed to evaluate and comparison the pathologic findings in remnant tissue
after NTT and STT. Thyroid tissue samples of 50 patients who underwent TT for MNG disease between January 2010 and August 2011
in our clinic were evaluated. Before the dissection of the thyroid tissue subtotal and neartotal margins were marked in both right and left
lobes. After the resection of the specimen, the tissue was excised from the subtotal and neartotal margin marked during the surgery.
The pathologic findings of the main tissue, the residual subtotal and neartotal tissues were evaluated and compared. All patients were
followed-up 1 year. 43 (86%) females and 7 (14%) males with an average age of 50.5 (23-77) were included in the study. Incidental
papillary thyroid cancer was detected in 5 patients (10%). Pathologic findings were present in 31 patients (62%) of subtotal residual
tissue and 28 of the patients (56%) of neartotal residual tissue. Papillary microcarcinoma was detected in 3 (9.7%) of subtotal residual
tissues and 2 (7.1%) of neartotal residual tissues. There is no significant difference between subtotal and neartotal tissues in terms of
existence of pathological findings (p>0.05). There is no significant difference between the neartotal and subtotal residual tissues
contralateral of dominant nodule (p>0.05). 2 of the patients (4%) had temporary hypocalcemia, 1 patient (2%) had seroma and 1 patient
(2%) had recurrent laryngeal nerve injury. There are high rates of microscopic pathological findings on residual tissues both after STT
and NTT. The neartotal and subtotal residual tissues contralateral to the large nodule also had high levels of pathologic findings.
(IJCEM1309011).
Keywords: Total thyroidectomy, subtotal thyroidectomy, neartotal thyroidectomy, residual tissue, multinodular goiter
Address correspondence to: Dr. Rojbin Karakoyun, Department of General Surgery, Antalya Training and Research Hospital, Varlık
Mh, 07050 Muratpasa, Antalya, Turkey. Tel: +90 5059127841; Fax: +90 242 249 44 62; E-mail: drrojbin@hotmail.com
