COMMENTARY ON THE PREVENTION OF THE RECUR RENCE BY THE THYROID-HORMONE

Hemithyroidectomy is the basic operation for isolate thyroid nodules o r unilateral multinodular goiters. However, surgeons must check the ab sence of controlateral nodules by palpation, in order to avoid residua l nodules that are not readily amenable to hormone therapy. In a revie w of 1456 goiters operated between 1968 and 1983, the authors identify only the multinodular nature as a significant risk factor of recurren ce. In view of the prevention of residual nodules, they note only 2.5 % recurrence. Although some studies demonstrate an increase in the TSH level after hemithyroidectomy, these results do not allow recommendin g systematic posteoperative hormone therapy. This seems to be justifie d only in a population at risks, namely patients with multinodular goi ter, increased postoperative TSH levels, thyroiditis or a family histo ry.