Comparison of Total Thyroidectomy and Lobectomy with Isthmusectomy in Treatment of Well-Differentiated Carcinoma of Thyroid Gland

Objective: To compare the outcomes between total thyroidectomy with lobectomy and isthmusectomy in the treatment of well differentiated carcinoma of thyroid gland. Design & duration: This quasi-experimental study was carried out from 27(th) January 2007 to 26(th) July 2007 Setting: Department of Surgery, Mayo Hospital Lahore. Patients and methods: Sixty patients histologically proven differentiated carcinoma of thyroid above 12 years of age were included in the study. Patients with toxic goitre and pregnant women with differentiated carcinoma of thyroid were excluded from the study. Patients were randomly divided in two groups; Group A (total thyroidectomy) and Group B (lobectomy with isthmusectomy). First followup visit was on first week after they were discharged from the hospital. Next three follow up visits were done at one month, two months and three months to look for any complication. Results: In group A there were 24 (80%) patients of papillary carcinoma and 6 (20%) patients of follicular carcinoma. In group B there were 22 (73.3%) patients of papillary carcinoma and 8 (26.7%) patients of follicular carcinoma. In the distribution of complications, there were 1 (3.3%) patient of hoarseness of voice in both groups, 1 (3.3%) patient of hypocalcaemia in both groups, 1 (3.3%) patient of seroma formation in both groups and no patient of recurrence in group A and 6(20%) patient of recurrent in group B. Conclusion: It is concluded that the total thyroidectomy is the best treatment option for differentiated carcinoma of the thyroid