Feasibility and Safety of Thyroid Tissue Auto-transplantation after Total Thyroidectomy for Simple Multinodular Goiter

Abstract

Background: Total thyroidectomy is currently considered the modality of choice for treatment of benign thyroid disorders. After surgery the patient becomes dependent on replacement therapy for life, thyroid tissue auto-transplantation provides the chance to avoid the need for life-long replacement therapy and to avoid post-thyroidectomy hypothyroidism in non-compliant patients.The Aim of the work: This work aimed to investigate the feasibility and safety of thyroid tissue auto-transplantation after total thyroidectomy for simple multinodular goiter.Patients and Methods: This study was designed to be an observational prospective study, conducted on 30 patients who were diagnosed with simple multinodular goiter and were submitted for total thyroidectomy followed by thyroid tissue auto- transplantation.Results: Postoperative hypocalcemia with range of serum calcium level from 7.6 to 8 mg/dl [normal value: 8.5 to 10.2 mg/dl] was found in six patients [20%], the final outcome one year after surgery showed that all the cases had a functioning viable transplanted thyroid tissue, but with different degrees of function, six cases [20%] had fully functioning implants [T3, T4, and TSH were normal during the hormonal analysis], 21 cases [70%] had minimally insufficient implants which had normal levels of thyroid hormones but they had a high level of TSH although the iodine scan showed viable functioning implants, and 3 cases [10%] had insufficient implants which had low levels of thyroid hormones and high level of TSH hormone.Conclusion: Thyroid auto-transplantation is a safe and easy procedure that provides survival and function of the thyroid implants and offers promising results in the majority of the selected patients.