Controversy continues regarding the indications and safety of total thyroidectomy in the treatment of thyroid cancer. Many reports have shown minimal morbidity following total thyroidectomy and recommend its use for all malignant disease of the
thyroid.
Other surgeons suggest to avoid total thyroidectomy bcause of the high risk of hypoparathyroidism and laryngeal nerve injury, and the leack of improved survival compared with partial thyroidectomy. In this report we reviewed our experience with
53
consecutive total thyroidectomies performed for thyroid cancer.
During a 11-year period (January 1982 to December 1992), 53 consecutive total thyroidectomies were performed at Soonchunhyang Hospital for thyroid cancer. There was no operative mortality, and only one patient had postoperative bleeding requring
reoperation. Four of five patients with paralyzed recurrent laryngeal nerves in the immediate postoperative period, vocal cord function returned in all. And one patient who occurred the permanent recurrent laryngeal nerve injury recovered 1 year
after
neurorrhaphy. 17 patients were developed hypoparathyroidism after total thyroidectomy. Among them 10 patients needed to take calcium only during their hospitalization, 4 patients for 1 month, 2 patients for 3 months and only 1 patient for more
than
6
months. Two years later, nobody took calcium.
Our experience suggests that the morbidity of total thyroidectomy is low, so total thyroidectomy shoud be considered as the primary treatment for thyroid cancer.
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