外科手术是治疗甲状腺癌的重要手段。甲状腺癌的手术方式主要分为两种：一种是甲状腺患侧腺叶全切除+峡部切除术，另一种是甲状腺患侧腺叶全切除+峡部切除+对侧腺叶全或近全切除术，俗称甲状腺全切除术。要根据肿瘤类型、大小、淋巴结转移情况及术后131I治疗情况综合考虑，并根据手术医生的外科经验合理选择术式。甲状腺全切除术能使肿块巨大、多灶或双侧癌灶、有淋巴结转移的病人受益，可以去除病灶并降低肿瘤复发率，但不可忽视的问题是术后并发症发生率要高于患侧腺叶切除+峡部切除手术。因此，要慎重选择甲状腺全切除手术方式。此外，要严格掌握甲状腺全切除术的适应证及相关手术技巧，以达到降低术后并发症发生率的目的。

The value and reasonable choice of total thyroidectomy in the surgical treatment of thyroid cancer        TIAN Wen*，YAO Jing. *Department of General Surgery，General Hospital of PLA，Beijing 100853，China
Corresponding author：TIAN Wen，E-mail：tianwen301@sina.com
Abstract    Surgery is an important method of thyroid cancer treatment. There are two common surgical methods for thyroid cancer treatment: one is the total resection of cancerous side plus isthmus, the other is the total resection of cancerous side, isthmus, and countralateral resection/total resection, which is known as total thyroidectomy. The tumor type, size, lymph node metastasis, postoperative 131I treatment as well as surgeon’s experience are considered to select specific method reasonable choice. The patients can benefit from total thyroidectomy with a huge mass, multifocal or bilateral foci, the presence of lymph node metastasis, and the lesion can be removed with low recurrences rate. Although, it can not be ignored that its higher incidence of postoperative complication compared with the ipsilateral lobectomy plus isthmus resection. So we should choose carefully the method of thyroidectomy surgery. In addition, total thyroidectomy should be strictly controlled indications and surgical techniques for reducing complications.