Although total thyroidectomy is controversial and sometimes denied for fear of an increased risk of postoperative complications such as seroma, bleeding, hypoparathyroidism and recurrent laryngeal nerve injury, minimal morbidity and low
complication
rate of total thyroidectomy were reported by recent studies. We reviewed our experiences with 77 total thyroidectomies out of 291 thyroid opertions for 18 months from December. 1992 to May 1994 at Kwangju Christian Hospital.
Among 77 total thyroidectomies, 19 were total thyroidectomy, 44 were total thyroidectomy with neck dissection and 14 were completion total thyroidectomy with or without neck dissection. Parathyroid glands were explored and identified in 73
cases(94.8%)
and at least 1 parathyroid was preserved in 71 cases(92.2%). In 49 patients hypocalcemia was developed and among them, 32(41.6%) needed calcium supply. But these patient need not take calcium after average of 10.1 days and no permanent
hypocalcemia
was
observed. The number of preserved parathyroid glands was irrelevant to the postoperative serum calcium level and the period of return to normal serum calcium level. Furthermore, it was not related to the period of calcium supply, either.
We conclude that total thyroidectomy is safe procedure if one or more parathyroid glands can be preserved and the preservation or autotransplantation of parathyroid glands is possible in all occasions with skillful handling. Thus total
thyroidectomy
should be considered as the treatment of choice in thyroid cancer without fear of the hypoparathyroidism and other complications.
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