Technique and results of total thyroidectomy in the treatment of thyroid cancer

The technique of total thyroidectomy currently employed is described in detail. Juxtacapsular section of the division branches of the inferior thyroid artery improves the safety of the procedure. Using this technique no patient had permanent hypoparathyroidism in the last 100 consecutive total thyroidectomies. Recurrent nerve palsy (1.5%) occurred only during lymphnodal dissection of the involved recurrent chains. Survival rates of 510 thyroid carcinomas operated on between 1967 and 1988 are reported. The 10 year survival rate is 87.6% for papillary, 57.8% for follicular, 75.6% for medullary and 0% for undifferentiated thyroid cancer. All the papillary and follicular cases treated by total thyroidectomy with neck dissection of necessity under 45 years were alive independent of the stage. No patient over 45 years at stage I and II died from the disease. Survival rates in stages III and IV decreased respectively to 83% and 43% in papillary and to 50% and 27% in follicular cancers.