XXXX : What is the adequate surgical therapy? A review of literature.

@entity1 @entity146 @entity1376 @entity189 @entity2319 @entity259 @entity4903
BACKGROUND: Benign @entity1376 (BMNG) is the most common @entity4903 requiring surgery. During the last few years a more @entity146 approach has become the trend for bilateral BMNG treatment. METHOD: Randomized clinical trials of any size that compared bilateral subtotal resection, Dunhill procedure and total thyroidectomy for benign @entity1376 , published between January 2000 and the end of March 2015, were reviewed. DISCUSSION: Total thyroidectomy can be considered the most reliable approach in preventing recurrence. The Dunhill procedure is related to a higher rate of recurrence, but rarely recurrences after Dunhill procedure lead to reoperation. Total thyroidectomy avoid completion thyroidectomy for incidental @entity189 and its related risks. Recurrent laryngeal nerve (RLN) palsy becomes less common as surgical experience increases. Transient and @entity2319 is strictly related to the extent of neck dissection. In the risk-cost analysis we must consider the type of @entity1 candidated to surgery and the impact of the surgical protocol we apply. When thyroid surgery is taken in consideration, specific complication rates of different procedures in each hospital must be analyzed accordingly to @entity1 -specific risk factors and local expertise. CONCLUSION: The Dunhill procedure seems to be a good compromise between radicality and prevention of complications, avoiding reoperation for recurrence or completion thyroidectomy for incidental @entity259 . More follow-up studies and prospective studies are necessary to better evaluate, definitively, whether to prefer total thyroidectomy or Dunhill procedure in case of benign goiter surgery.
