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Year : 2009  |  Volume : 6  |  Issue : 3  |  Page : 75-78

Principles of thyroid surgery

Department of General Surgery, Amrita Institute of Medical Sciences, Elamakkara, P.O Cochin-41, India

Correspondence Address:
C G Nair
Department of General Surgery, Amrita Institute of Medical Sciences, Elamakkara, P.O Cochin-41
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Source of Support: None, Conflict of Interest: None

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Operations on the thyroid glands were considered risky until Theodore Kocher 's masterly expositions of surgical practice on the gland. Thyroid nodules are still noted up to about 5% population even in iodine sufficient area. The evaluation of otherwise asymptomatic nodules is directed towards detecting a hidden malignancy. The role of operation in malignant nodule is unquestioned but the extend of resection is still debated. Though medical management and non-surgical interventions for benign nodules are under trial, thyroidectomy still remains the procedure of choice in most of occasions. The scenario of surgical practice in benign nodule is also changing with the swing towards total extirpation of the gland. Thyroidectomy always carried the risks of laryngeal nerve palsy and hypocalcaemia. The present day practice of surgical procedure, incorporating the principles of identifying external division of superior laryngeal nerve and capsular dissection of lateral lobes, has markedly reduced the rates of complications to less than 1% in large series. Synthetic thyroxine is universally available and cheap since 1950 and so total resection of the gland is acceptable to most of the patients except very few with lack of proper drug compliance.

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