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Drs Hines and Winchester are to be congratulated on the technical success achieved in this study. Only a few of their patients experienced temporary hypocalcemia and recurrent laryngeal nerve paresis, which I agree is generally of minor concern, and they did not incur either complication on a permanent basis. However, avoidance of these complications does not in itself signify that total thyroidectomy is superior to a more conservative procedure, such as near-total thyroidectomy (NTT), in the treatment of papillary thyroid cancer.
The authors investigated two primary objectives: (1) the advisability of total lobectomy as the initial procedure for a suspicious thyroid nodule and (2) the advantage of total thyroidectomy for treatment of differentiated thyroid cancer. I agree entirely with their first conclusion, stressing as they did the risk of reoperation to complete resection of a lobe that had been only partially removed previously.
I do not agree with the authors'
Grant CS. Invited Commentaries. Arch Surg. 1993;128(9):1064. doi:10.1001/archsurg.1993.01420210128020