Three thousands one hundred and thirty-three patients were referred to the Department of Endocrine Surgery, Third Chair of General Surgery, Jagiellonian University College of Medicine in Krakow, Poland, for first-time thyroid surgery between January 2000 and December 2003. Of this group, 694 patients were eligible for this study, while 94 patients refused to participate. Finally, 600 patients who signed the informed consent were randomized to three groups equal in size (n = 200): TT, DO, and BST. Thirty patients were lost to follow-up at 5 years, leaving 570 who were followed for at least 60 months: 191 in the TT group, 189 in the DO group, and 190 in the BST group. Further 44 patients were lost to follow-up at 10 years, leaving 526 who were followed for at least 120 months: 177 in the TT group, 174 in the DO group, and 175 in the BST group (Fig. 1). Demographic characteristics of patients in this study are shown in Table 1. In this study, indications for initial surgery for MNG were: presence of compressive symptoms in a patient with a thyroid nodule/s of 3 cm or larger (n = 412), indeterminate result of FNA suggestive of an increased risk for malignancy (n = 91), discrepancy between the suspicious ultrasound phenotype of the dominant thyroid lesion/s, and the FNA result suggestive for non-diagnostic or benign lesion (n = 45), particularly in cases of a cold thyroid scanning, multiple bilateral thyroid lesions not responding to TSH suppressive treatment with l-thyroxine (n = 49), and on patient’s request for cosmetic indications (n = 3). All indications were equally distributed between the three study arms.Fig. 1Flow diagram of the study Table 1Demographic characteristics of 526 patients who completed the 10-year follow-upTT n = 177DO n = 174BST n = 175Sex ratioa (M:F)15:16218:15615:160Mean ageb (years)45.9 ± 13.947.0 ± 15.347.9 ± 15.2Preoperative TSHb (mIU/L)1.87 ± 0.841.82 ± 0.811.80 ± 0.91Preoperative thyroid volume (assessed by ultrasound)a (mL)75.8 ± 38.477.8 ± 39.578.8 ± 39.9 TT total thyroidectomy, DO Dunhill operation, BST bilateral subtotal thyroidectomy a χ 2 test b t-test; statistically nonsignificant differences for all values