Total thyroidectomy for benign thyroid disease: when and why.

Surgical complications after total thyroidectomy (TT) and subtotal thyroidectomy (STT) are analysed in a series of 364 patients operated on over a 36-month period. All operations were carried out because of the following 3 groups of disease: malignant tumors, multinodular goiter and Graves' disease. The difference among the incidence of surgical complications resulted to be not statistically significant when as discriminating factors the type of surgery or disease were used, while the difference was statistically significant when the results obtained in the 2 groups of patients operated only once or undergoing reoperative surgery for recurrence, were compared. Based on these observations, the surgical approach consistent with the above mentioned types of thyroid disease is reported, and the preference for total thyroidectomy is justified to a larger extent by what has been done to-date also in case of benign thyroid disease. The choice of the type of surgery should always be made, based on a careful clinical and intraoperative assessment of each case.