[Our trend in conservative surgery in differentiated carcinoma of the thyroid].
OBJECTIVE
Report as contribution to the controversy between supporters of total thyroidectomy versus "less than total" thyroidectomy.


METHODS
42 patient operated on over six years; 35 treated with total thyroidectomy, 7 with lobohystmectomy.


RESULTS
In the patients who underwent total thyroidectomy we observed recurrent nerve lesions in 5.7%, hypoparathyroidism in 14.3% and 1 lymph nodal relapse (it was a cancer stay III); in patients who underwent lobohystmectomy, we observed 1 temporary recurrent nerve palsy (14.2%) and 1 lymph nodal relapse (14.2%).


CONCLUSIONS
The choice between total thyroidectomy and lobohystermectomy depends upon different goals: reduction in risk of relapse in total thyroidectomy, to minimize complications in lobohystmectomy. In our series the risk of lymph nodal relapse seems to depend more on biological characters of the tumour than surgical tech of  lymphadenectomy; however, this occurrence does not change prognosis.


CONCLUSIONS
In our experience, potential multifocality of the disease, low risk of hyatrogenic lesions and easy postoperatory management make total thyroidectomy the our preferred technique. Informed consensus is mandatory in order to involve the patients to the best choice.
Scerrino
G
G
Divisione di Chirurgia Generale, d'Urgenza e dei Trapianti di Organo Università di Palermo, Policlinico Via del Vespro, 129 96100 Palermo.
Romano
G
G
Salamone
G
G
Farulla
M Airò
MA
Salamone
S
S
Gambino
G
G
Pompei
G
G
Buscemi
G
G
D018263:Adenocarcinoma, Follicular / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012737:Sex Factors; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D013997:Time Factors