title: Total thyroidectomy as the single surgical option for benign and malignant thyroid disease: a surgical challenge.
abstract: BACKGROUND
  Total thyroidectomy has been the treatment of choice for patients with malignant thyroid disease. However, the efficacy and safety of this procedure for patients with benign disease is still a matter of debate. The aim of this study is to show that total thyroidectomy can be safely performed for both malignant and benign disease.
  
  
  METHODS
  A retrospective study on 216 patients was conducted. Once an indication for surgery was established, our single surgical treatment was total thyroidectomy. Age, sex, nature of thyroid disease, final pathology and postoperative complications were recorded.
  
  
  RESULTS
  For both benign and malignant disease, total thyroidectomy resulted in no permanent laryngeal nerve injury and no permanent hypoparathyroidism. Temporary laryngeal nerve palsy occurred in 0.9% and 3% of patients with benign and malignant disease respectively (p = 0.245). Six percent of patients with benign and 10.0% of patients with malignant thyroid disease suffered temporary hypoparathyroidism (p = 0.280). Immediate reoperation for postoperative hemorrhage was performed in 1.7% of patients with benign disease and in 1.0% of patients with malignancy with an uneventful outcome (p = 0.650).
  
  
  CONCLUSIONS
  When performed by surgeons experienced in endocrine surgery, total thyroidectomy may be considered as the treatment of choice for both malignant and benign thyroid disease requiring surgical treatment. Total thyroidectomy virtually eliminates the requirement of completion thyroidectomy for incidentally diagnosed thyroid carcinoma and significantly reduces the rate of reoperation for recurrent disease, as it provides an immediate and permanent cure for all benign thyroid diseases, with a low incidence of postoperative complications.
authors.affiliation: Second Department of Surgery, School of Medicine, University of Athens, Aretaieion Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vassiliou
authors.forename: Aliki
authors.initials: A
authors.lastname: Tympa
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos
authors.forename: Fotios
authors.initials: F
authors.lastname: Nikolakopoulos
authors.forename: Thalia
authors.initials: T
authors.lastname: Petropoulou
authors.forename: Vassilios
authors.initials: V
authors.lastname: Smyrniotis
keywords: benign thyroid disease; thyroid cancer; total thyroidectomy