الفهرس 
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Abstract
This study was conducted on 60 patients with simple multinodular goiter during the period from April 2000 to April 2002 inclusive, they were diagnosed, treated and followed up in the endocrine surgery unit Mansoura University Hospital. Altogether, 53 patients were female and 7 patients were males. Their age ranged from 13 to 57 years with a mean age of 35 years. Patients randomly assigned to one of two treatment groups: • Group A: Patients with subtotal thyroidectomy (34 patients). • Group B: Patients with total thyroidectomy (26 patients). All patients were subjected to careful history taking, complete clinical examination, laboratory and radiological examination, total and subtotal thyroidectomy by the standard technique and finally strict postoperative follow up 2 weeks, 3 months, 6 months and one year after surgery. Total thyroidectomy complicated with, transient astymptomatic hypocalcaemia in 38.5% of patients, manifest hypocalcaemia in (7.7%), transient unilateral partial RLN injury in 11.5%, unilateral permanent RLN injury in 3.8%, no recurrence. Subtotal thyroidectomy complicated with transient astymptomatic hypocalcaemia 23.5% of patients, manifest hypocalcaemia 3%, transient unilateral partial RLN injury in 5.9%, no unilateral permanent RLN injury occurred, recurrence in 8.8% for them completion thyroidectomy was done and complicated with partial unilateral RLN injury in 33.3% and manifest hypocalcaemia in 33.3%. From this study, we concluded that: • There is no significant difference between total and subtotal thyroidectomy regarding postoperative complications as hypoparathyroidism (transient or permanent), RLN injury (transient or permanent) and recurrence. • In patients with simple nodular goiter, it is advised to do total thyroidectomy to guard against postoperative recurrence of the goiter that may necessitate surgical intervention where there is a great liability for injury of the parathyroids and/or RLN nerve during the redo surgical intervention. • In patients where subtotal or total thyroidectomy was performed, it is advised to give Ltroxine replacement therapy which is better to be calculated in patients with total thyroidectomy. • Total thyroidectomy is advised to be done by experienced endocrine surgeon who is aware by the postoperative complications that may result from injury of the recurrent laryngeal nerve and/or the parathyroid glands during operation.