CHANGING TRENDS IN THYROID-SURGERY AT THE NSTITUTO-NACIONAL-DE-LA-NUTRICION-SALVADOR-ZUBIRAN

The diagnosis and treatment of thyroid disease has significantly chang ed-with time. With the aim of analysing changes in thyroid surgery in our institution, a representative sample of patients from the first th ree years in four decades (1960-1992) were comparatively analysed. In the sixties, the diagnosis of thyroid cancer was made during surgery; by contrast, this diagnosis was correctly done by fine needle aspirati on (FNA) in most patients of the last decade. Thyroid lobectomy, infre quently used in the treatment of differentiated thyroid carcinoma in e arlier times, has now been abandoned and currently most patients under go total or near-total thyroidectomy. Complications such as hypoparath yroidism and recurrent laryngeal nerve paralysis have importantly decr eased with time and were not seen in the last decade. A trend toward a n earlier diagnosis of thyroid carcinoma was also observed. In summary , the number of thyroidectomies for benign diseases has been important ly reduced by the use of FNA with the proportional increment of surger y for malignant disease.