THE LONG‐TERM OUTCOME OF THYROIDECTOMY FOR SPORADIC NON‐TOXIC GOITRE

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Abstract
To study the long-term outcome after thyroidectomy, 113 sporadic non-toxic goitre patients who underwent thyroidectomy in our hospital in the period 1974-1983, were studied. Five patients complained of recurrent goitre; a goitre was found on inspection and palpation in these five and in 15 others. There were no differences between the 20 patients with goitre and the 93 patients without goitre with regard to sex, age duration of goitre, indication and type of thyroidectomy, postoperative thyroid hormone medication, period of followup, and T4, T3, or TSH plasma values at the time of follow-up examination. Twenty-three patients complained of voice changes since thyroidectomy. In a case control study, included in this follow-up study, 19 patients with goitre, i.e. thyroid size I and II as estimated by inspection and palpation (cases), and 16 patients without goitre, i.e. thyroid size OA and OB (controls), were studied in more detail. No difference between cases and controls was found in any of the above mentioned parameters that could explain the recurrence of goitre. Thyroid volume (median) was greater in the cases (34.1 ml, range 7.9-83.4) than in the controls (10.3 ml, range 2.5-48.7) (P < 0.001), although a considerable overlap between the two groups was observed. One or more thyroid nodules were found in 89.5% of the cases and in 62.5% of the controls (NS). Serum thyroid growth stimulating immunoglobulin (TGI) was present both in cases (68%) and controls (50%). TGI was present in high titres in all five patients who complained about recurrent goitre. Thyroid volume was negatively related to the plasma level of TSH (r = -0.36, P< 0.05), and positively but not significant to serum TGI. In conclusion: (1) a goitre is found in 17.7% of sporadic non-toxic patients at long-term follow-up after thyroidectomy, not related to age, sex, duration of goitre, indication or type of operation, postoperative thyroid hormone medication, period of follow-up, or plasma T3, T4, or TSH; (2) TGI is more prevalent in patients who complain of recurrent goitre after thyroidectomy, (3) thyroidal nodular disease persists in the majority of patients after thyroidectomy.