XXXX : the case for total thyroidectomy.

@entity1 @entity3557 @entity129 @entity6081 @entity2319 @entity261 @entity3243 @entity259 @entity912
Since there are no prospective studies concerning the treatment of @entity259 , there continues to be a considerable disagreement about the 'best' or most appropriate form of surgical treatment for @entity1 with @entity3557 . Some surgeons recommend selective treatment depending upon the type of @entity259 and stage of the disease. Some advocate thyroid lobectomy and isthmusectomy, some near total thyroidectomy, and some total thyroidectomy for @entity1 with @entity3557 . Total thyroidectomy for @entity259 would be the treatment of choice for virtually all @entity1 with @entity259 if it could be done without complications. We therefore reviewed 160 consecutive @entity1 who had total thyroidectomy for suspected or proven @entity259 to determine the complication rate of total thyroidectomy. One hundred and three @entity1 had primary operations, 57 had reoperations with completion of total thyroidectomy and 124 had @entity259 . Serious complications (i.e. vocal @entity912 or @entity261 ) included two cases of transient bilateral recurrent @entity129 , two @entity1 with presumed transient unilateral vocal @entity912 , three recurrent laryngeal nerves that were purposely sacrificed because of invasion of the nerve, and one case of @entity2319 . Two other @entity1 developed @entity6081 . Only one of the permanent complications, the case of @entity2319 , could have been avoided by a lesser procedure. The experienced surgeon can perform a total thyroidectomy with minimal morbidity, and this procedure has certain theoretical and practical advantages. It should not be done, however, if it will result in a significant complication rate and, in selected @entity1 , it may be preferable to leave a small amount of thyroid tissue to protect the blood supply to the @entity3243 or recurrent laryngeal nerve.
