Comparison of the Results of Subtotal Thyroidectomy with Hartley-Dunhill Operation in Surgical Patients

Document Type : Original Article

Authors

1 Department of Surgery, School of Medicine, Qom University of Medical Sciences, Qom, Iran

2 Department of Family and Community Medicine, School of Medicine, Qom University of Medical Sciences, Qom, Iran

Abstract

Background: Thyroid resection surgeries used to treat many thyroid diseases may be performed as a total or subtotal thyroidectomy. This study aimed to compare two methods of subtotal thyroidectomy (omission from both sides) with the Hartley-Dunhill procedure in patients with thyroid diseases.
Methods: In this retrospective study, the records of all patients who underwent thyroidectomy between 2017 and 2018 were evaluated. Demographic information (age and sex) of patients, initial diagnosis and pathology, type of surgery, serum calcium level on the fourth day after surgery, parathyroid nerve damage, and hematoma were collected using patients’ files. Finally, complications in the two groups were measured.
Results: A total number of 100 patients, including 67 female (67%) and 33 male (33%) individuals, were studied. The mean age of patients in the Hartley-Dunhill subtotal thyroidectomy group was 12.65±40.75 years and in the non-Hartley-Dunhill surgery group was 12.86±38.91 years. There was no association between two groups in terms of indications of surgery (P=0.235), postoperative pathology (P=0.754), postoperative hematoma (P=0.11), postoperative recurrence (P=0.714), and the postoperative calcium level (P=0.816). However, the difference in recurrent laryngeal nerve injury occurrence was statistically significant between the groups (P=0.03).
Conclusion: Findings of this study showed that there was no significant difference between the groups regarding complications of the surgery, except nerve damage, and the recurrence rate in both methods was clinically pretty low.

Keywords

References

  1. Chi SY, Hsei KC, Sheen-Chen SM, Chou FF. A prospective randomized comparison of bilateral subtotal thyroidectomy versus unilateral total and contralateral subtotal thyroidectomy for graves' disease. World J Surg. 2005; 29(2):160-3. doi: 10.1007/s00268-004-7529-7.
  2. Stålberg P, Svensson A, Hessman O, Akerström G, Hellman P. Surgical treatment of Graves' disease: Evidence-based approach. World J Surg. 2008; 32(7):1269-77. doi: 10.1007/s00268-008-9497-9.
  3. Maschuw K, Schlosser K, Lubbe D, Nies C, Bartsch DK. Total versus near-total thyroidectomy in Graves' disease and their outcome on postoperative transient hypoparathyroidism: Study protocol for a randomized controlled trial? Trials. 2012; 13:234. doi: 10.1186/1745-6215-13-234.
  4. Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, et al. American thyroid association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016; 26(10):1343-421. doi: 10.1089/thy.2016.0229.
  5. Porseyedi, B., Zenalinejhad, H., Moslemi-Aghili, S., Aghaei-Afshar, M., Lashkarizadeh, M., Sanjari, M., Yosefzadeh, G., Gozashti, M. Comparison of the Frequency of Recurrent Laryngeal Nerve Injury with and without Exploration of the Nerve in Thyroidectomy. Journal of Kerman University of Medical Sciences, 2012; 19(3): 300-307.
  6. Unalp HR, Erbil Y, Akguner T, Kamer E, Derici H, Issever H. Does near total thyroidectomy offer advantage over total thyroidectomy in terms of postoperative hypocalcemia? Int J Surg. 2009; 7(2):120-5. doi: 10.1016/j.ijsu.2008.12.003.
  7. Liu J, Bargren A, Schaefer S, Chen H, Sippel RS. Total thyroidectomy: A safe and effective treatment for Graves' disease. J Surg Res. 2011; 168(1):1-4. doi: 10.1016/j.jss.2010.12.038.
  8. Erbil Y, Barbaros U, Salmaslioglu A, Yanik BT, Bozbora A, Ozarmagan S. The advantage of near-total thyroidectomy to avoid postoperative hypoparathyroidism in benign multinodular goiter. Langenbecks Arch Surg. 2006; 391(6):567-73. doi: 10.1007/s00423-006-0091-z.
  9. Harness JK, Fung L, Thompson NW, Burney RE, McLeod MK. Total thyroidectomy: complications and technique. World J Surg. 1986; 10(5):781-6. doi: 10.1007/BF01655238.
  10. Rayes N, Steinmuller T, Schröder S, Klotzler A, Bertram H, Denecke T, et al. Bilateral subtotal thyroidectomy versus hemithyroidectomy plus subtotal resection (Dunhill procedure) for benign goiter: Long-term results of a prospective, randomized study. World J Surg. 2013; 37(1):84-90. doi: 10.1007/s00268-012-1793-8.
  11. Reeve TS, Curtin A, Fingleton L, Kennedy P, Mackie W, Porter T, et al. Can total thyroidectomy be performed as safely by general surgeons in provincial centers as by surgeons in specialized endocrine surgical units? Making the case for surgical training. Arch Surg. 1994; 129(8):834-6. doi: 10.1001/archsurg.1994.01420320060011.
  12. Barczynski M, Konturek A, Hubalewska-Dydejczyk A, Gołkowski F, Cichon S, Nowak W. Five-year follow-up of a randomized clinical trial of total thyroidectomy versus Dunhill operation versus bilateral subtotal thyroidectomy for multinodular nontoxic goiter. World J Surg. 2010; 34(6):1203-13. doi: 10.1007/s00268-010-0491-7.
  13. Mishra A, Agarwal G, Agarwal A, Mishra SK. Safety and efficacy of total thyroidectomy in hands of endocrine surgery trainees. Am J Surg. 1999; 178(5):377-80. doi: 10.1016/s0002-9610(99)00196-8.
  14. Lennquist S. The thyroid nodule: Diagnosis and surgical treatment. Surgical Clinics of North America. 1987; 67(2):213-32. doi: 10.1016/S0039-6109(16)44180-0.
  15. Steinmuller T, Ulrich F, Rayes N, Lang M, Seehofer D, Tullius SG, et al. Operationsverfahren und risikofaktoren in der therapie der benignen struma multinodosa. ein statistischer vergleich der komplikationshaufigkeit. Chirurg. 2001; 72(12):1453-7. German. doi: 10.1007/s001040170010.

 

Journal of Kerman University of Medical Sciences
Volume 29, Issue 2
March and April 2022
Pages 158-162

Files

Share

How to cite

Statistics