[The selection of surgical technique for differentiated thyroid carcinoma].

OBJECTIVE

To evaluate the optimal extent of primary thyroidectomy and neck dissection in the patients with differentiated thyroid carcinoma (DTC).

METHOD: Retrospective analysis of 66 cases of DTC. Lobectomy for tumor side plus subtotal lobectomy for another side was performed in 49 cases, lobectomy with isthmectomy was performed in 7 cases, subtotal lobectomy for one side plus partial lobectomy for another side was performed in 6 cases, total thyroidectomy was performed in 4 cases. Unilateral functional neck dissection for another side was performed in 1 case and unilateral traditional neck dissection in 5 cases.

RESULT: The 5 and 3 years survival rates were 94% and 96%. All 4 cases operated with total thyroidectomy suffered hypothyroidism and 2 of them had hypoparathyroidism postoperatively. There was no hypothyroidism and hypoparathyroidism for other cases. No recurrent nerve paralysis occurred in this group.

CONCLUSION

We recommend lobectomy for tumor side plus subtotal lobectomy for another side for most of DTC. Selective neck dissection is not necessary for N0 cases unless the patient is in high risk group.