The surgical treatment of thyroid cancer. The primary disease.

Controversy surrounding the surgical treatment of thyroid cancer is discussed. The various approaches are lobectomy, isthmusectomy and lobectomy, subtotal thyroidectomy (sparing the capsule and some tissue on the contralateral side in an effort to decrease the complications of bilateral recurrent nerve paralysis and hypoparathyroidism), and total thyroidectomy. The surgical treatment options for each histologic type of thyroid gland malignancy are also discussed. For well-differentiated carcinomas of the thyroid, a strong case is made for total thyroidectomy.