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) 37:84–90 DOI 10.1007/s00268-012-1793-8 Bilateral Subtotal Thyroidectomy Versus Hemithyroidectomy Plus Subtotal Resection (Dunhill Procedure) for Benign Goiter: Long-Term Results of a Prospective, Randomized Study • • Nada Rayes Thomas Steinmu ¨ ller • • • Sabine Schro ¨ der Andre Klo ¨ tzler Helga Bertram • • Timm Denecke Peter Neuhaus Daniel Seehofer Published online: 2 October 2012 Socie ´te ´ Internationale de Chirurgie 2012 Abstract incidence of recurrent nerve palsy and hypoparathyroidism. Background Two recent meta-analyses of mostly retro- In all patients, ultrasonography of the thyroid and measure- spective studies have shown high recurrence rates follow- ment of serum calcium and parathyroid hormone were per- ing subtotal resection of bilateral multinodular goiter. formed. Recurrent nerve function was analyzed by indirect Therefore, many endocrine centers have changed their laryngoscopy. Long term data ([10 years after surgery) were operative procedures in favor of thyroidectomy. Conse- available in 70 DO patients and 65 BST patients. Mean fol- quently, the rate of complications, especially hypopara- low-up was 11.3 ± 4.2 years (10–12 years). thyroidism, has increased. Hemithyroidectomy plus Results No differences were seen in the operating times, subtotal resection (Dunhill operation) overcomes some transient and permanent hypoparathyroidism, or recurrent disadvantages of bilateral subtotal resection (BST). We nerve palsy. In the long-term, mean thyroid volumes were performed a prospective, randomized trial to compare the significantly lower in the DO group (3.5 ± 3.5 vs. Dunhill operation (DO) and BST for benign goiters. 6.4 ± 6.5 ml, p = 0.01). One reoperation was required in the Methods Between October 1994 and March 1997, a total of BST group because of recurrence versus none in the DO 200 consecutive patients were randomized into...