Comparative study of conservative resection and radical operation for thyroid carcinomas

Abstract

Objective: To compare mortality and morbidity in management of thyroid cancers by total lobectomy (C-R) and near-total thyroidectomy (R-0) and to relate pathological subtype to prognosis. Design: A retrospective study of patients with thyroid cancers that were managed
during an eleven-year period. Setfing: Jos University Teaching Hospital, Nigeria. Subjects: A total of 44 patients who underwent C-R (n = 26) and R-0 (n = 18) were studied. Intervention: A total of 509 goitrous specimens including the excised thyroid cancers were histopathologically studied. Main outcome measurers: Cases were analysed for mortality and morbidity data in
the two groups during a partial follow-up period of two years. Results: Mortality figures for C-R was 4% versus 11 for R - 0. Postoperative haemorrhage occurred in 14% for C-R versus six for R-0. Similarly, bilateral vocal cord paralysis occurred in 11% versus 22; voice changes in 11 % versus 33, transitory hypoparathyroidism 8 % versus 50, local recurrence in 18 % versus eleven. Hypothyroidism occurred in all patients undergoing R-0 and stitch granuloma in 11 %
of patients in C-R group versus six for R-0. Follicular carcinoma constituted 59% of the total number thyroid cancers with papillary cancer constituting 35%. Conclusion: C-R is recommended as the operation of choice for thyroid cancers.