[Surgical indications and techniques in Basedow's disease, multinodular goiter and thyroid cancers]

This is a retrospective study of 47 near total and 30 total thyroidectomies for multinodular goiter, Graves' disease and thyroid cancer. Complications are rare: one permanent recurrent nerve palsy out of 154 nerves at risk, one definitive hypoparathyroidism. For a benign pathology, the former bilateral sub-total thyroidectomy should be replaced by a near-total thyroidectomy which leaves one unilateral thyroid remnant the size of a cherry. Using this technique, we did not observe any recurrence. Among 42 patients controlled after more than one year 1/3 have a normal thyroid function. Systematic substitution is not indicated. Thyroxine should be used only if hypothyroidism develops after the operation or if an increase of the thyroid remnant is demonstrated. Thyroid cancer should be treated by total thyroidectomy, except for noninvasive papillary cancer without node metastasis for which a total lobectomy is sufficient.