title: [Total thyroidectomy: indications and complications].
abstract: OBJECTIVE
  To investigate the indications and complications of the total thyroidectomy in the management of thyroid cancer.
  
  
  METHODS
  Fifty-one patients with thyroid cancer operated with total thyroidectomy in a period from April 2007 to June 2010, were retrospective analyzed. There were 48 cases of papillary adenocarcinoma, 1 follicular adenocarcinoma, and 2 medullary carcinoma as well, 2 cases with hyperthyroidism, 3 cases with remote metastasis. There were 17 males and 34 females who in their age ranged from 5 years old to 82 years old with a middle age of 50 years old. Among the 45 cases who were initial surgical management patients, there were 17 T1, 13 T2, 7 T3, 8 T4; and there were 31 N0, 11 N1a, 3 N1b, 2 M1. The recurrent laryngeal nerve and the parathyroid gland, and supper laryngeal nerve were exposed routinely. Lymph nodes in Level VI were dissected in all patients, and Level II-IV dissected in 25 patients. ¹³¹I were administrated in 8 patients.
  
  
  RESULTS
  Patients were followed up from 1 month to 36 months. There were no patients died and lost of follow up. The two years survival rate was 100.0% (15/15). Pathological examination showed that the multiple focal disease rate was 42.2% (19/45), the cervical lymph nodes metastases rate was 51.0% (26/51). There was no permanent paralysis of recurrent laryngeal nerve and outer branch of supper laryngeal nerve. The permanent hypoparathyroidism rate was 3.9% (2/51). One case with contralateral lymph node metastasis was reoperated and survived without disease. Two cases with remote metastasis were alive with steadied disease.
  
  
  CONCLUSIONS
  Under the skilled hand, total thyroidectomy is a safe procedure in the management of thyroid cancer. Totally exposing the parathyroid gland and laryngeal nerve is the key point to prevent the major complications.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otorhinolaryngology, Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education (Capital Medical University), Beijing 100730, China.
authors.forename: Ju-gao
authors.initials: JG
authors.lastname: Fang
authors.forename: Hong-zhi
authors.initials: HZ
authors.lastname: Ma
authors.forename: Zhong-bao
authors.initials: ZB
authors.lastname: Zhang
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Huang
authors.forename: Xiao-hong
authors.initials: XH
authors.lastname: Chen
authors.forename: Wei-guo
authors.initials: WG
authors.lastname: Zhou
authors.forename: Xue-jun
authors.initials: XJ
authors.lastname: Chen
authors.forename: De-min
authors.initials: DM
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018276:Carcinoma, Medullary / Q000601:surgery; D018278:Carcinoma, Neuroendocrine; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D055815:Young Adult