Toxic multinodular goiter surgery

Toxic multinodular goiter Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2],Sunny Kumar MD [3]

Overview

• Surgical intervention is not recommended for the management of [disease name].

OR

• Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
• The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
• The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

• Surgery is the mainstay of treatment for [disease or malignancy].

Surgery

Surgery is the mainstay of treatment for Toxic multinodular goiter.

Indications

Indications of surgery for multinodular goiter (MNG) includes:

• Rapid enlargement of goiter
• Rapidly enlarging thyroid nodules
• FNAC is positive or suspicious of malignancy
• Compression of trachea, esophagus, and other neck structures
• Risk of malignancy
  • Suspicious cervical lymphadenopathy
  • Radiation exposure

Surgical procedures

Almost all multinodular goiters can be surgically removed through a collar incision. An additional thoracotomy is very rarely necessary.

Subtotal thyroidectomy

Bilateral subtotal thyroidectomy is effective in the treatment of multinodular goiter (with hot or cold nodules).

Unilateral Lobectomy

A unilateral lobectomy may be performed if only one thyroid lobe is enlarged.

Side effects of surgery

The side effects associated with thyroidectomy include:

• Post-operative hypothyroidism
• Recurrent laryngeal palsy
• Hypocalcaemia