One of the many controversies sorrounding the treatment of thyroid cancer is the extent of surgical resection for well-differentiated thyroid carcinoma. The benefits of total thyroidectomy as the initial therapy of well-differentiated thyroid
cancer
have been well documented by many authors. But the opponents of total thyroidectomy cite the high local complication the procedure. Postoperative complications of thyroidectomy seem to be underestimated frequently because the majority of them are
temporary and do not result in permanent or serious damage. So, to determine the morbidity rate according to the extent of surgery, we reviewed 145 patients who had undergone thyroidectomy at Ewha Womans University Hospital from Oct. 1988 to Mar.
1995.
@ES The results were as follows:
@EN 1) The most common complication after thyroidectomy was transient hypocalcemia (18.6% in total thyroidectomy, 12.5% in subtotal or near-total thyroidectomy, 5.4% in lobectomy) The relationship between transient hypocalcemia and the extent of
surgery
was statistically significant. (P<0.05)
2) The second most common complication was transient hoarseness. (8.6% in total thyroidectomy, 4.1% in subtotal or near-total thyroidectomy, 2.7% in lobectomy)
3) There were no postoperative airway complication and no patients had wound hemorrhage requiring reoperation. There were two case of permanent recurrent laryngeal nerve damage in lobectomy and subtotal thyroidectomy, and one permanent
hypoparathy-roidism following total thyroidectomy.
4) The overall morbidity was 13.5% in lobectomy, 18.8% in subtotal or near-total thyroidectomy and 39.5% in total thyroidectomy. The relationship between the morbidity and the extent of surgery was statistically significant(P<0.05).
5) For prognostically favorable thyroid carcinoma, the possible benefit of total thyroidectomy must be balanced against the prospect of increased morbidity.
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