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The retrospective analysis of 7016 operations of the thyroid (1978-1985) showed an increase of operations of cold nodules from 23% to 52%. The rate of malignancy of cold nodules decreased from 7.2% to 6.3%. But, the intensive operative management of cold nodules resulted in an increase of operations of low stage tumors. Therefore radical operation of thyroid tumors was possible in 68.3% of cases. An elevated rate of malignancy is observed, if a cold nodule is associated with the following criteria: solitary, solid, male patients, younger than 30 and older than 60 years.

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A short historical introduction is given about vascular ligature in goitre surgery. By means of various experiments an attempt was made to investigate the effect of various types of vascular ligatures on the thyroid gland. In addition on the basis of follow-up examinations of patients operated on for goitre, the effect of vascular ligature on recurrence was examined. The results of these investigations cast doubt on the value of ligature of all four thyroid arteries required by some investigators (Huber 1967; Kreiner 1952; Steiner 1960) as a prophylactic measure against the danger of recurrence.