TOTAL THYROIDECTOMY FOR DIFFERENTIATED THYROID-CARCINOMA - PRIMARY AND SECONDARY OPERATIONS

Aims: There is considerable controversy concerning the most appropriat e surgical treatment of patients with differentiated thyroid carcinoma (DTC). Although some authors have advocated subtotal thyroidectomy be cause of the decreased surgical morbidity and the lack of improved sur vival with a more extensive procedure, total thyroidectomy has been de fended by others as a treatment of choice with lower morbidity. Method s: We reviewed 106 consecutive patients who had been treated with tota l thyroidectomy for DTC to determine the complication rate. Forty-seve n patients had primary operations and 59 had reoperations with complet ion of total thyroidectomy. Results: Residual tumour in the remnant th yroid tissue was found in 53.8% of patients who underwent prophylactic completion thyroidectomy. Permanent hypoparathyroidism was present in one (0.9%) patient and accidental transient unilateral recurrent lary ngeal nerve injury occurred in 2.8% of the entire series. No patient h ad permanent bilateral recurrent nerve palsy. Furthermore, the risk of complication was not significantly different when comparing primary t otal thyroidectomy or completion surgery. Conclusions: We recommend to tal thyroidectomy as a safe treatment for DTC with a low rate of morbi dity.