Outcomes of Total Thyroidectomy in Multinodular Goitre: Insights from a Tertiary Care Centre in Kashmir

Abstract

Background: Multinodular goitre (MNG) continues to be a common surgical problem in regions with a history of iodine deficiency, including the Kashmir valley. Although iodisation programmes have reduced the overall prevalence of goitre, patients frequently present late with large, symptomatic multinodular goitres requiring definitive surgical management.

Objectives: To analyse the demographic profile, clinical presentation, surgical outcomes, and postoperative follow-up of patients undergoing total thyroidectomy for benign multinodular goitre at a tertiary care centre in the Kashmir valley.

Methods: A retrospective observational study was conducted on 40 consecutive patients who underwent total thyroidectomy for benign multinodular goitre between January 2021 and December 2024. Demographic data, clinical presentation, thyroid functional status, operative details, histopathology, and postoperative outcomes were analysed descriptively.

Results: Of the 40 patients, 36 (90%) were female. The mean age was 46.2 ± 10.7 years (range 20–66 years). Long-standing neck swelling was the most common presentation (87.5%), while 35% of patients had compressive symptoms and 20% had toxic multinodular goitre. All patients underwent total thyroidectomy. Transient hypocalcaemia occurred in 8 patients (20%), and transient recurrent laryngeal nerve (RLN) palsy in 2 patients (5%). One patient had permanent RLN palsy. No patient developed permanent hypoparathyroidism or mortality.

Conclusion: Total thyroidectomy for benign multinodular goitre in the Kashmir valley is a safe and effective procedure with low permanent morbidity when performed in experienced hands. It offers definitive treatment with minimal risk of recurrence and acceptable complication rates.

Keywords: Multinodular goitre, total thyroidectomy, hypocalcaemia, recurrent laryngeal nerve injury, Kashmir