September 1993

Total Lobectomy and Total Thyroidectomy in the Management of Thyroid Lesions

Author Affiliations

From the Department of Surgery, Northwestern University Medical School, Chicago, Ill.

Arch Surg. 1993;128(9):1060-1063. doi:10.1001/archsurg.1993.01420210124018

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 diagnosid 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 thryoid tumors.(Arch Surg. 1993;128:1060-1064)