[Extension of thyroidectomy in the treatment of benign nodular thyroid diseases]

A series of 268 benign nodular goitres, operated on in a 10-year period, is presented. Subtotal thyroidectomy was the chosen operation; however, during the first period of our experience, when the goitre was obviously limited to one lobe we performed unilateral lobectomy in some cases. After surgery no patient received hormone therapy without previous evaluation of thyroid function. Thyroid function was evaluated after surgery and alterations were corrected. As recurrent goitre was a rare occurrence and complications of subtotal thyroidectomy are low, we do not support total thyroidectomy for nodular goitre. In order to avoid recurrences hemithyroidectomy no longer must be performed: the surgical treatment of nodular goitre is carried out by subtotal thyroidectomy, leaving little residual thyroid, to spare parathyroids and inferior laryngeal nerves, which is usually enough for adequate hormone production; in the case of TSH raising, thyroxine must be given.