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Comparative study of conservative resection and radical operation for thyroid carcinomas.

OBJECTIVE
To compare mortality and morbidity in management of thyroid cancers by total lobectomy (C-R) and near-total thyroidectomy (R-O) and to relate pathological subtype to prognosis.


DESIGN
A retrospective study of patients with thyroid cancers that were managed during an eleven-year period.


SETTING
Jos University Teaching Hospital, Nigeria.


SUBJECTS
A total of 44 patients who underwent C-R (n = 26) and R-O (n = 18) were studied.


INTERVENTION
A total of 509 goitrous specimens including the excised thyroid cancers were histopathologically studied.


MAIN OUTCOME MEASURES
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-O. Postoperative haemorrhage occurred in 14% for C-R versus six for R-O. 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-O and stitch granuloma in 11% of patients in C-R group versus six for R-O. 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.