Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1983 May;197(5):542–549. doi: 10.1097/00000658-198305000-00007

Total thyroidectomy. A review of 213 patients.

J K Jacobs, J W Aland Jr, J F Ballinger
PMCID: PMC1353029  PMID: 6847273

Abstract

During a 10.5-year period ending in June 1982, total thyroidectomy was performed on 213 patients at the Vanderbilt University Medical Center. A nonfunctioning nodule on technetium scan was the primary indication for operation. Twenty-one of 213 patients had undergone previous partial thyroidectomy. The pathologic changes in the excised thyroids were carcinoma (81 patients), thyroiditis (27 patients), multiple benign adenoma (16 patients), thyrotoxicosis (27 patients), multinodular goiter (56 patients), and C-cell hyperplasia (three patients). Three total thyroidectomies were performed in search of a parathyroid adenoma. Fourteen patients had coexistent primary hyperparathyroidism. Excluding 12 patients with medullary carcinoma, 25% of all other patients with carcinoma would have had unrecognized tumor left in the remaining lobe had a total thyroidectomy not been performed. Calcium supplements were required in 59 patients during hospitalization, but only 2.8% of the patients developed permanent hypoparathyroidism. Since the adoption of Thompson's technique of total thyroidectomy, only one of the 128 patients (0.8%) has sustained permanent hypoparathyroidism. Two patients exhibited transient recurrent laryngeal nerve palsies without permanent nerve damage. There were no operative deaths. The low morbidity of total thyroidectomy appears to justify its use in all patients with differentiated thyroid malignancy. With surgeons experienced in this technique, total thyroidectomy should also be considered as the primary treatment for many other patients requiring thyroidectomy.

Full text

PDF
542

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Attie J. N., Moskowitz G. W., Margouleff D., Levy L. M. Feasibility of total thyroidectomy in the treatment of thyroid carcinoma: postoperative radioactive iodine evaluation of 140 cases. Am J Surg. 1979 Oct;138(4):555–560. doi: 10.1016/0002-9610(79)90418-5. [DOI] [PubMed] [Google Scholar]
  2. BEAHRS O. H., VANDERTOLL D. J. COMPLICATIONS OF SECONDARY THYROIDECTOMY. Surg Gynecol Obstet. 1963 Nov;117:535–539. [PubMed] [Google Scholar]
  3. Beierwaltes W. H. The treatment of thyroid carcinoma with radioactive iodine. Semin Nucl Med. 1978 Jan;8(1):79–94. doi: 10.1016/s0001-2998(78)80009-9. [DOI] [PubMed] [Google Scholar]
  4. Block M. A. Management of carcinoma of the thyroid. Ann Surg. 1977 Feb;185(2):133–144. doi: 10.1097/00000658-197702000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Buckwalter J. A., Thomas C. G., Jr Selection of surgical treatment for well differentiated thyroid carcinomas. Ann Surg. 1972 Oct;176(4):565–578. doi: 10.1097/00000658-197210000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. CLARK R. L., Jr, WHITE E. C., RUSSELL W. O. Total thyroidectomy for cancer of the thyroid: significance of intraglandular dissemination. Ann Surg. 1959 Jun;149(6):858–866. doi: 10.1097/00000658-195906000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Clark O. H. Total thyroidectomy: the treatment of choice for patients with differentiated thyroid cancer. Ann Surg. 1982 Sep;196(3):361–370. doi: 10.1097/00000658-198209000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Crile G., Jr Changing end results in patients with papillary carcinoma of the thyroid. Surg Gynecol Obstet. 1971 Mar;132(3):460–468. [PubMed] [Google Scholar]
  9. Dozois R. R., Beahrs O. H. Surgical anatomy and technique of thyroid and parathyroid surgery. Surg Clin North Am. 1977 Aug;57(4):647–661. doi: 10.1016/s0039-6109(16)41280-6. [DOI] [PubMed] [Google Scholar]
  10. Edis A. J. Surgical treatment for thyroid cancer. Surg Clin North Am. 1977 Jun;57(3):533–542. doi: 10.1016/s0039-6109(16)41235-1. [DOI] [PubMed] [Google Scholar]
  11. Esselstyn C. B., Jr A technique for thyroidectomy. Surg Clin North Am. 1975 Oct;55(5):1031–1045. doi: 10.1016/s0039-6109(16)40731-0. [DOI] [PubMed] [Google Scholar]
  12. FRAZELL E. L., FOOTE F. W., Jr Papillary cancer of the thyroid; a review of 25 years of experience. Cancer. 1958 Sep-Oct;11(5):895–922. doi: 10.1002/1097-0142(195809/10)11:5<895::aid-cncr2820110506>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  13. Farrar W. B., Cooperman M., James A. G. Surgical management of papillary and follicular carcinoma of the thyroid. Ann Surg. 1980 Dec;192(6):701–704. doi: 10.1097/00000658-198012000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Harwick R. D. Thyroid cancer--surgical decision making. Semin Oncol. 1980 Dec;7(4):392–399. [PubMed] [Google Scholar]
  15. Hubert J. P., Jr, Kiernan P. D., Beahrs O. H., McConahey W. M., Woolner L. B. Occult papillary carcinoma of the thyroid. Arch Surg. 1980 Apr;115(4):394–398. doi: 10.1001/archsurg.1980.01380040028004. [DOI] [PubMed] [Google Scholar]
  16. Jakimowicz J. J., Mak B., Stockmann C. H. Results of surgical treatment for hyperthyroidism. Arch Chir Neerl. 1979;31(3):141–149. [PubMed] [Google Scholar]
  17. Katz A. D., Bronson D. Total thyroidectomy. The indications and results of 630 cases. Am J Surg. 1978 Oct;136(4):450–454. doi: 10.1016/0002-9610(78)90259-3. [DOI] [PubMed] [Google Scholar]
  18. Loré J. M., Jr Surgery of the thyroid gland. Otolaryngol Clin North Am. 1980 Feb;13(1):69–83. [PubMed] [Google Scholar]
  19. Mazzaferri E. L. Papillary and follicular thyroid cancer: a selective approach to diagnosis and treatment. Annu Rev Med. 1981;32:73–91. doi: 10.1146/annurev.me.32.020181.000445. [DOI] [PubMed] [Google Scholar]
  20. Moosman D. A., DeWeese M. S. The external laryngeal nerve as related to thyroidectomy. Surg Gynecol Obstet. 1968 Nov;127(5):1011–1016. [PubMed] [Google Scholar]
  21. Nahodil V. On the question of technique of total thyroidectomy. Acta Univ Carol Med (Praha) 1977;23(3-4):143–150. [PubMed] [Google Scholar]
  22. Neel H. B., 3rd, Townsend G. L., Devine K. D. Bilateral vocal cord paralysis of undetermined etiology. Clinical course and outcome. Ann Otol Rhinol Laryngol. 1972 Aug;81(4):514–519. doi: 10.1177/000348947208100409. [DOI] [PubMed] [Google Scholar]
  23. Perzik S. The place of total thyroidectomy in the management of 909 patients with thyroid disease. Am J Surg. 1976 Oct;132(4):480–483. doi: 10.1016/0002-9610(76)90324-x. [DOI] [PubMed] [Google Scholar]
  24. ROSE R. G., KELSEY M. P., RUSSELL W. O., IBANEZ M. L., WHITE E. C., CLARK R. L. FOLLOW-UP STUDY OF THYROID CANCER TREATED BY UNILATERAL LOBECTOMY. Am J Surg. 1963 Sep;106:494–500. doi: 10.1016/0002-9610(63)90136-3. [DOI] [PubMed] [Google Scholar]
  25. Sawyers J. L., Martin C. E., Byrd B. F., Jr, Rosenfeld L. Thyroidectomy for hyperthyroidism. Ann Surg. 1972 Jun;175(6):939–947. doi: 10.1097/00000658-197206010-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Scanlon E. F., Kellogg J. E., Winchester D. P., Larson R. H. The morbidity of total thyroidectomy. Arch Surg. 1981 May;116(5):568–571. doi: 10.1001/archsurg.1981.01380170050009. [DOI] [PubMed] [Google Scholar]
  27. Sedgwick C. E. Surgery of the thyroid gland. Major Probl Clin Surg. 1980;15:159–187. [PubMed] [Google Scholar]
  28. Shapiro S. J., Friedman N. B., Perzik S. L., Catz B. Incidence of thyroid carcinoma in Graves' disease. Cancer. 1970 Dec;26(6):1261–1270. doi: 10.1002/1097-0142(197012)26:6<1261::aid-cncr2820260613>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  29. Simpson W. J., Palmer J. A., Rosen I. B., Mustard R. A. Management of medullary carcinoma of the thyroid. Am J Surg. 1982 Oct;144(4):420–422. doi: 10.1016/0002-9610(82)90415-9. [DOI] [PubMed] [Google Scholar]
  30. Thompson N. W., Nishiyama R. H., Harness J. K. Thyroid carcinoma: current controversies. Curr Probl Surg. 1978 Nov;15(11):1–67. doi: 10.1016/s0011-3840(78)80004-5. [DOI] [PubMed] [Google Scholar]
  31. Thompson N. W., Olsen W. R., Hoffman G. L. The continuing development of the technique of thyroidectomy. Surgery. 1973 Jun;73(6):913–927. [PubMed] [Google Scholar]
  32. Tollefsen H. R., Shah J. P., Huvos A. G. Follicular carcinoma of the thyroid. Am J Surg. 1973 Oct;126(4):523–528. doi: 10.1016/s0002-9610(73)80043-1. [DOI] [PubMed] [Google Scholar]
  33. Tollefsen H. R., Shah J. P., Huvos A. G. Papillary carcinoma of the thyroid. Recurrence in the thyroid gland after initial surgical treatment. Am J Surg. 1972 Oct;124(4):468–472. doi: 10.1016/0002-9610(72)90068-2. [DOI] [PubMed] [Google Scholar]
  34. Tweedle D., Colling A., Schardt W., Green E. M., Evered D. C., Dickinson P. H., Johnston I. D. Hypothyroidism following partial thyroidectomy for thyrotoxicosis and its relationship to thyroid remnant size. Br J Surg. 1977 Jun;64(6):445–448. doi: 10.1002/bjs.1800640620. [DOI] [PubMed] [Google Scholar]
  35. Wang C. The use of the inferior cornu of the thyroid cartilage in identifying the recurrent laryngeal nerve. Surg Gynecol Obstet. 1975 Jan;140(1):91–94. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES