J.Jpn. Surg. Soc.. 91(9): 1108-1111, 1990

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Report on the annual meeting

DEVELOPMENT OF THYROID SURGERY; PAST, PRESENT AND FUTURE

Thyroid surgeous have treated four groups of thyroid diseases ; thyroiditis, Graves' disease, benign nodules and malignant neoplasms. Nowerdays surgery is not adopted in the treatment of subacute thyroiditis and Hashimoto's disease, but is required in some patients with acute suppurative thyroiditis which was revealed an inflammatory disorder of the pyriform-sinus fistula. As for Graves' disease, surgery is still recommended in Japan for the youth whose disease has been resistent to drug therapy. The indication for surgery is determined clinically with the help of determination of plasma TSHreceptor antibody, thyroglobulin and TSH levels. Beta-blockade and adrenocortical steroid are also useful to suppress the plasma concentration of thyroid hormones preoperatively.
Benign thyroid nodules include adenoma and adenomatous goiter. The latter was first disclosed as one of the clinicopathological entities in 1968 and was found a harmless lesion so far as it remained small in size and euthyroid. Fine needle aspiration biopsy has provided an accurate, quick and economical diagnostic approach in discrimination of malignant neoplasms from benign lesions. With development of new operative procedures, total thyroidectomy has become available without causing permanent hypoparathyroidism. Also aggressive surgical treatment including a sleeve resection of the trachea has been adopted for locally invasive differentiated carcinomas.

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