الفهرس 
IntroductionOnly 14 pages are availabe for public view
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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 . Also this study points out the most important 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 40 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 % while the incidence of permanent RLN palsy was 0% and the incidence of transient 95 hypoparathyroidism was 15% while no cases suffered from permanent hypoparathyroidism . 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 . 2. An added advantage to total thyroidectomy is avoiding secondary surgical intervention for patients with histologic surprise who are proved by histopathology to have hidden micro foci of malignancy. 3. Hemostasis is technically more easily secured in total thyroidectomy than in subtotal thyroidectomy. As in total thyroidectomy all vessels are identified and tied while subtotal thyroidectomy leaves residual vascularized thyroid tissue. 4. Routine intraoperative identification of both RLNs and parathyroid glands is a must in order to perform a total radical surgery and to decrease the incidence of their accidental injury. 5. The incidence of RLN injury and hypoparathyroidism after total thyroidectomy is acceptably low in experienced hands and is documented in literature to be nearly the same as in subtotal 96 thyroidectomy which renders total thyroidectomy a safe and acceptable procedure for benign thyroid diseases. from our study we recommend total thyroidectomy as the routine surgical procedure of choice in benign thyroid diseases as it is safe and easy procedure.