Total lobectomy and total thyroidectomy in the management of thyroid lesions
J. R. Hines and D. J. Winchester
Department 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.
