Predictive factors for recurrent non-toxic goitre in an endemic region

Abstract

Aims: We aimed to determine the risk factors for recurrence and to assess the complication rate associated with surgery for benign, recurrent goitre.

Methods: We studied 125 consecutive patients with recurrent goitre who underwent re-operative thyroid surgery (group one). Patients in the control group were randomly selected from those undergoing their first procedure during the same period (group two). Age, initial surgery, presence of multinodular goitre, presence of carcinoma in the resected thyroid tissue, interval between initial operation and re-operation, and complications were analysed and compared for the two groups.

Results: The mean age (± standard deviation) was found to be significantly greater in group one compared with group two. The mean age at the time of primary thyroid operation was found to be significantly less in group one compared with group two. The interval between the initial and the re-operative procedures was a mean of 15.8±eight years. Initial surgery was conservative. Papillary thyroid carcinoma was found in 14/125 (11 per cent) of group one patients. The incidence of complications was found to be significantly higher in group one compared with group two.

Conclusion: The incidence of recurrent goitre has been directly related to conservative thyroid surgery and to the retention of large amounts of remnant tissue. To avoid recurrent goitre and possible re-operative complications, total or near-total thyroidectomy should be performed in all patients with bilateral, multinodular goitre, especially in endemic regions.