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Abstract The extent of thyroidectomy in benign thyroid diseases is still a matter of controverse and shows a large spectrum of management strategies. The aim of all these procedures is to perform the most effective treatment with the least complications, without the incidence of recurrence and without the need for secondary surgical intervention which will be very difficult and hazardous due to disturbed anatomy and adhesions with a higher incidence of RLN injury and/or hypoparathyroidism. This work aimed to compare the safety, efficacy, incidence of complications and surgical outcome in patients operated upon for benign thyroid diseases applying total thyroidetomy and subtotal thyroidectomy discussing opinions with and against applying both procedures in benign thyroid diseases. This study points out the most important complication of total thyroidectomy which are RLN injury and hypoparathyroidism comparing their incidence to that associated with subtotal thyroidectomy also this study points out the mostimportant complication of subtotal thyroidectomy ”recurrence” which is absent in case of total thyroidectomy as recurrence takes the patient to the risk of secondary surgical intervention which will be very difficult and hazardous. Our study comprised 140 patients with benign thyroid diseases.All patients had been subjected to full clinical assessment, routine laboratory studies, thyroid profile, neck US, indirect laryngoscopy and FNAC and thyroid scan when indicated and no patient was allowed to be operated upon unless becomes adequately prepared and euthyroid. Postoperative follow up for these patients revealed that the incidence of transient RLN palsy was 1.3% in both groups while the incidence of permanent RLN palsy was0% and the incidence of transient hypoparathyroidism was 5.7%for the 1st group and4.2% for the 2nd group while no cases suffered from permanent hypoparathyroidism and 7 histologic surprise (malignancy) in our study3 for the 1st group and 4 for the 2nd group. This study points out that the incidence of complications is nearly the same as the international literature incidence of complications associated with total and subtotal thyroidectomy At the end this study emphasized that there is an obvious decrease in the incidence of complications associated with total thyroidectomy especially with increasing experience and refinement of surgical technique. from this work, we concluded that: 1) Total thyroidectomy is recommended as the routine procedure of choice in benign thyroid diseases because it avoids leaving residual unhealthy thyroid tissue liable for recurrence with or without superimposed malignancy and 2) the risk of complications in the secondary surgical intervention is extremely higher. |