Factors Associated With Intraoperative Conversion to Total Thyroidectomy in Benign Goiters

Abstract

Background: Decision to undertake total thyroidectomy when gross inspection of the gland raises suspicion of widespread degenerative changes is often intraoperative. Knowing the factors associated with intraoperative conversion to total thyroidectomy may assist preoperative counselling. This study describes the probability of conversion to total thyroidectomy and factors associated with con-version among patients hitherto planned for partial thyroidectomy. Methods: We reviewed 191 records and extracted data on patient demographics, the pre-operative radiograph findings, the weight of excised gland and the operation performed. Descriptive and inferential statistics were performed. Receiver operator curve was used to assess for cut-off point. P-value was set at 0.05. Results: A total of 191 records was reviewed consisting of 181 females (94.8% 95% CI 90.6-97.5) and 10 males (5.2%, 95%CI 2.5-9.4). Only nodular goiters required conversion to total thyroidectomy. The over-all probability of total thyroidectomy was 11%(95% CI 7.0-16.3). The probability of total thyroidectomy in female was 10.5%(95% CI 6.4-16.9) while in male was 20%(95% CI2.5-55.6). The probability of total thyroidectomy in a female with nodular goiter was 8.1%(95% CI 4.8-13.5), compared to 28.6%(95% CI 3.7-71) in males. The risk of total thyroidectomy was associated with the weight of the excised gland. Conclusion: Only nodular goiters required intraoperative conversion to total thyroidecto-my and the probability of conversion was higher in males.