Management of recurrent goiter; the challenges and achievements
Mohamed Nagi, Saad Altaleb, Intekhab Alam
Background: one of the major challenges of the surgical management of goiter remains the assessment as to which goiter will develop recurrence and which will not develop recurrence after conservative surgery. since surgery of the goiter has been greatly influenced by Theodor Kocher all over the world, the traditional conservative Kocher type of surgical resection of the goiter showed to harbor the problem of a high recurrence rate after conservative surgery ( mentioned in many of the literatures as high as 2 to 70%).
Objective: To determine the different factors responsible for the recurrence of goiter, and to verify and discuss the difference between conservative and radical surgery of goiter in regard this challenge.
Results: The total number of cases were 1350, 115 males and 1195 females, the age range from 19 to 72 years old, all of the cases presented with goiter and operated with different procedures, there was 42 cases presented with recurrence after follow up for 1 to 10 years (recurrence rate 3.1%). all the recurrence cases were reoperated and their morbidity were compared to the group which not develop recurrence.
Conclusion: surgery of goiter is one of the common surgical procedures performed in our hospitals. experience hands is needed to reduce the recurrence rate of this disease. our experience confirms the results of a review of literature on this topic : the best management of recurrent goiter is its prevention by primary total thyroidectomy.