[Plea for large excision of the thyroid gland in benign diseases (retrospective study 1986-1996)].

Abstract

According to the literature and the study of 158 patients who have been examined, operated and analysed by the same medicosurgical staff, the authors have found a great frequency of clinical and echographic recurrencies. This frequency has also been found by others teams. The study of the different factors for goitrogenesis, either in multiplication of thyrocytes or tissular differentiation shows the pathogenic polymorphism. For the polynodular lesions, most of them located in the 2 lobes, total thyroidectomy seems to be the only procedure to prevent recurrencies. For the nodular lesions, most of the time unilateral, recurrencies are due to the fact that infracentimetric lesions have not been detected by preoperative ultrasonography and scintigraphy. They are discovered by postoperative ultrasonography and the long time follow-up is not to this date sufficient. The palpation and the peroperative ultrasonographic verification of the remaining lobe seem to be the best attitude to avoid the growth of small undetected lesions.