[Hemithyroidectomy. A consecutive series of 100 patients]

Treatment of isolated, scintigraphically cold thyroid nodules in the thyroid gland by means of hemithyroidectomy ensures that, in patients with thyroid carcinoma, it is possible subsequently to carry out total thyroidectomy by means of an intervention limited to the contralateral surgically intact side. The object of the present investigation to assess whether this therapeutic strategy was rational and safe. Hemithyroidectomy was carried out in 67 patients on account of a "cold nodule" while the remaining 33 patients were submitted to operation on other indications. Out of the 67 patients, one (2%) had a papillary carcinoma, 53 (79%) had follicular adenomata, 12 (18%) had nodular goitre and one (2%) had Hashimoto's thyroiditis. In the entire material, one case (1%) of permanent hypocalcaemia was encountered. None of the patients developed paresis of the recurrent laryngeal nerve. Reoperation proved necessary in one patient (1%) on account of postoperative heamorrhage. It is concluded that hemithyroidectomy is a rational primary method of treatment in cases with suspected malignant disease in the thyroid gland. Non-neoplastic conditions may be excluded with reasonable certainty by preoperative clinical assessment and thyroid scintigraphy and ultrasound scanning. The intervention is safe and every thyroid surgeon should be capable of performing the operation.