Total extracapsular thyroidectomy versus subtotal thyroidectomy in nonmalignant goiter

Introduction: There is still a debate on the management strategies for diffuse benign thyroid diseases mainly between total extracapsular and subtotal thyroidectomy in terms of efficacy and complications. Aim: To establish the best operative management of benign thyroid diseases and to determine postoperative complications. Patients and methods: A prospective comparative study was carried out on patients with benign thyroid disease. Two types of surgical procedures were performed: total extracapsular thyroidectomy and subtotal thyroidectomy. Results: The study included 60 patients operated for benign thyroid disease. Controlled toxic goiter was found in 36 patients (60%), simple multinodular goiter was found in 14 patients (23.3%), primary toxic goiter was found in eight patients (13.3%), and a dominant toxic nodule was found in two patients (3.3%). Thirty patients underwent total extracapsular thyroidectomy and the other 30 patients underwent subtotal thyroidectomy. In this study, one patient (3.3%) from the total thyroidectomy group developed a complication of transient recurrent laryngeal nerve injury compared with no patients (0%) in the subtotal thyroidectomy group. Also, in this study, two patients (6.7%) in the total thyroidectomy group developed complications of hypoparathyroidism and hypocalcemia, but not in patients (0%) in the subtotal thyroidectomy group. Conclusion: Total extracapsular thyroidectomy is a safe and highly effective procedure, with low postoperative complications.