OBJETIVO: discutir as indicações da tireoidectomia total como opção preferencial em determinadas doenças benignas da tireóide, com a finalidade de evitar recidivas ou futuras reoperações. MÉTODOS: estudo retrospectivo de pacientes portadores de doenças benignas da tireóide, realizado no período de janeiro de 1997 a dezembro de 2009, analisando os dados relativos à idade, tratamento cirúrgico, evolução pós operatória. RESULTADOS: A idade média foi de 51,8 anos (21/77), sendo a maior incidência na quinta e sexta décadas de vida, com 34 (51,5%) pacientes. O diagnóstico mais comum no pré operatório foi de bócio multinodular atóxico, onde sete tinham características de mergulhantes, seguido da tireoidite autoimune; os bócios recidivados foram 11. O bócio multinodular foi encontrado em 37 (56,1%)pacientes, a tireoidite autoimune em 22 (33,3%), o adenoma folicular isolado em cinco (7,6%), o adenoma de células de Hürthle em dois (3,0%). Dezesseis pacientes (24,2%) tiveram mais de um diagnóstico histopatológico. A lesão permanente de nervo recorrente foi observada em um paciente (1,5%). Não foi registrado nenhum caso de hipoparatireoidismo definitivo. Não houve mortalidade operatória. CONCLUSÃO: a tireoidectomia total é uma operação que pode ser realizada com segurança e baixa incidência de complicações permanentes, o que permite ampliar suas indicações nas diversas doenças benignas da tireóide evitando, assim, futuras recidivas e reoperações.

OBJECTIVE: To review the indications for total thyroidectomy as the preferred option in certain benign diseases of the thyroid in order to prevent recurrence or future reoperations. METHODS: A retrospective study of patients with benign thyroid diseases, carried out from January 1997 to December 2009, analyzing the data relating to age, surgical treatment and postoperative evolution. RESULTS: The mean age was 51.8 years (21/77), with the highest incidence in the fifth and sixth decades of life, with 34 (51.5%) patients. The most common preoperative diagnosis was nontoxic multinodular goiter, of which seven were also intrathoracic, followed by autoimmune thyroiditis; recurrent goiter occurred in 11 cases. Multinodular goiter was found in 37 (56.1%) patients, autoimmune thyroiditis in 22 (33.3%), follicular adenoma isolated in five (7.6%), Hurthle cell adenoma in two (3.0%). Sixteen patients (24.2%) had more than one histopathological diagnosis. Permanent injury of the recurrent nerve was observed in one patient (1.5%). There was no case of permanent hypoparathyroidism. There was no operative mortality. CONCLUSION: Total thyroidectomy is an operation that can be safely performed, with low incidence of permanent complications, which allows one to broaden its indications in various benign thyroid diseases, thus avoiding future recurrences and reoperations.

The authors present a case report of a pancreatic pseudocyst with an unusual spleen involvement. The aspects of this rare complication are discussed, as well as the probable etiologic factors. The outcome was satisfactory and the surgical treatment consisted of the resection of its thick capsule, since the local anatomic conditions would not permit a splenectomy with distal pancreatectomy, considered to be the ideal surgery.

The authors present two cases of Primary Hiperaldosteronism, caused by functioning adenoma of the adrenal's cortex. The two females patients presented classic symptoms of the Conn's disease, especially hypocalemia and hypertension. Both were operated and unilateral adrenalectomy was done, with excelent outcome in one and satisfactory in the other one. It is discussed many aspects related to the incidence, the problems with the diagnosis, indication and surgery treatment.