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Total lobectomy and total thyroidectomy in the management of thyroid lesions
1Department of Surgery, Northwestern University Medical School, Chicago, Ill.
Objective:
To study an unselected consecutive series of patients undergoing thyroidectomy for tumors to establish the complication rates of total lobectomy with isthmectomy and total thyroidectomy.
Design:
Retrospective study.
Patients:
Two hundred eight consecutive, unselected patients were operated on by one surgeon from 1980 to 1990. One hundred nineteen patients (57%) had a total lobectomy and isthmectomy and 85 patients (41%) had total thyroidectomy. Four patients (2%) had partial excision for technical reasons, two with anaplastic cancers and two with advanced thyroiditis.
Results:
Forty-two malignant lesions (20%) were diagnosed with a mean follow-up of 5 years. Malignant lesions were diagnosed in 15 (31%) of 48 males and 27 (17%) of 160 women. Ten patients (5%) had parathyroid adenomas. Long-term follow-up revealed that there were no deaths, permanent hypocalcemia, or recurrent laryngeal nerve damage. One patient was returned to the operating room to control bleeding.
Conclusion:
This study suggests that total thyroid lobectomy with isthmectomy and total thyroidectomy are both safe procedures in the management of thyroid tumors.