[Total thyroidectomy: indications and complications].

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 adnocarcinoma, 1 follicular adnocarcinoma, and 2 medullary carcinoma as well, 2 cases with hyperthyroidisms, 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 NO, 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 25patients. 131Ⅰ were administrated in 8 patients. Results Patients were followed up from 1 month to 36months. 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. Key words: Thyroid neoplasms; Carcinoma, papillary; Adenocarcinoma, follicular; Carcinoma, medullary; Thyroidectomy