Advertisement

Thyroidectomy

  • Jameson L. Chassin

Abstract

Most patients with diffuse hyperthyroidism or Grave’s disease are now treated with radioactive iodine. This method has the advantage of simplicity and safety, although a longer period of time is required to correct the hyperthyroidism than is necessary with surgery. Operating on a toxic thyroid gland is more difficult than excising a solitary adenoma. The gland is larger and more vascular, especially if the patient has been prepared with propylthiouracil or methimazole. A recent advance in this area has been the use of propanolol for the preoperative preparation of a toxic patient. When an adequate dose has been administered, the symptoms of hyperthyroidism disappear quite rapidly and the thyroid gland is less vascular than is the case after the more traditional preparatory medications. Nevertheless, even a highly skilled thyroid surgeon experiences a 5% morbidity rate, including laryngeal nerve damage (less than 1%) and permanent hypoparathyroidism (less than 1%). Transient postoperative hypoparathyroidism may occur in an additional 55–10% of cases.

Keywords

Thyroid Cancer Thyroid Gland Thyroid Nodule Parathyroid Gland Recurrent Laryngeal Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Attie JN (1979) Feasibility of total thyroidectomy in the treatment of thyroid carcinoma. Am J Surg 138: 555PubMedCrossRefGoogle Scholar
  2. Becker FO, Economou SG, Southwick HW (1975) Adult thyroid cancer after head and neck irradiation in infancy and childhood. Ann Intern Med 83: 347PubMedGoogle Scholar
  3. Block MA (1983) Surgery of thyroid nodules and malignancy. Curr Probl Surg 20: 137CrossRefGoogle Scholar
  4. Block MA, Dailey GE, Robb JA (1983) Thyroid nodules indeterminate by needle biopsy. Am J Surg 146: 72PubMedCrossRefGoogle Scholar
  5. Blum M, Rothschild M (1980) Improved non-operative diagnosis of the solitary “cold” thyroid nodule: surgical selection based on risk factors and three months of suppression. JAMA 243: 242PubMedCrossRefGoogle Scholar
  6. Cady B, Sedgewick CE, Meissner WA, Brookwalter Jr et al. (1976) Changing clinical pathology, therapeutic, and survival patterns in differentiated thyroid carcinoma. Ann Surg 184: 541PubMedCrossRefGoogle Scholar
  7. Cady B, Sedgewick CE, Meissner WA, Wool MS et al. (1979) Risk factor analysis in differentiated thyroid cancer. Cancer 43: 810PubMedCrossRefGoogle Scholar
  8. Clark OH (1982) Total thyroidectomy: the treatment of choice for patients with differentiated thyroid cancer. Ann Surg 196: 361PubMedCrossRefGoogle Scholar
  9. Clark RL, White SC, Russell WD (1959) Total thyroidectomy for cancer of the thyroid: significance of intraglandular dissemination. Ann Surg 149: 858PubMedCrossRefGoogle Scholar
  10. Dobyns BM, Sheline GE, Workman JB (1974) Malignant and benign neoplasms of the thyroid in patients treated for hyperthyroidism: a report of the cooperative thyrotoxicosis therapy follow-up study. J Clin Endocrin 38: 976CrossRefGoogle Scholar
  11. Mazzaferri EL, Young RL, Oertel JE, Kemmerer WT et al. (1977) Papillary thyroid carcinoma: the impact of therapy in 576 patients. Medicine 56: 171PubMedCrossRefGoogle Scholar
  12. Paloyan E (1977) Operation for the irradiated gland for possible thyroid carcinoma: criteria, technique, and results, in DeGroot LJ, (ed.), Radiation—associated thyroid carcinoma, New York, Grune and StrattonGoogle Scholar
  13. Rosen IR, Wallace C, Strawbridge HG, Walfish PG (1981) Reevaluation of needle aspiration cytology in detection of thyroid cancer. Surgery 90: 747PubMedGoogle Scholar
  14. Tollefson HR, Shah JP, Huvos AG (1972) Papillary carcinoma of the thyroid: recurrence in the thyroid gland after initial surgical treatment. Am J Surg 124: 97Google Scholar
  15. Wanebo HJ, Andrews W, Kaiser DL (1981) Thyroid cancer: some basic considerations. Am J Surg 142: 472CrossRefGoogle Scholar
  16. Wells SA Jr. Ross AJ, Dale JK, Gray RS (1979) Transplantation of the parathyroid glands: current status. Surg Clin North Am 59: 167PubMedGoogle Scholar
  17. Woolner LB, Beahrs OH, Black BM (1968) Thyroid carcinoma: general considerations and follow-up data on 1,181 cases, in Young S, Inman DR (eds.), Thyroid neoplasia, London, Academic PressGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1984

Authors and Affiliations

  • Jameson L. Chassin
    • 1
    • 2
    • 3
    • 4
    • 5
  1. 1.New York University School of MedicineUSA
  2. 2.Booth Memorial Medical CenterFlushingUSA
  3. 3.University Hospital, New York University Medical CenterUSA
  4. 4.New York Veterans Administration HospitalUSA
  5. 5.Bellevue HospitalUSA

Personalised recommendations