Management of the thyroid nodule

Lobectomy-isthmectomy is part of our standard diagnostic approach for the solitary "cold" nodule of the thyroid. Although the majority of these prove to be benign, there is no noninvasive technique that can rule out malignant disease. It is necessary that the attendant morbidity for diagnostic surgery be extremely low. In our experience thyroid surgery for benign disease carries minimal risk. Resection of a lobe and isthmus with exploration and palpation of the opposite side constitutes our routine surgical management of the "cold" nodule. The nerve is always identified and preserved. In the past 18 months two minor complications have occurred postoperatively in 36 consecutive cases in which the lobe and isthmus were resected for benign disease.