The following criteria were used to define recurrence of nodular lesions within the remnant thyroid tissue (the same as previously reported in the Miccoli study): presence of hypoechoic or hyperechoic nodular pattern at least 5 mm in diameter, identification of perinodular hypoechogenic or hyperechogenic halo, and presence of an anechoic lesion with a reinforced posterior wall . FNA was electively performed during the follow-up period in all the cases of identified thyroid lesions larger than 1 cm in diameter within the remnant thyroid tissue. The following indications for reoperation were used: presence of a 3 cm, or larger nodule, result of FNA suggestive of an increased risk for malignancy, and presence of compressive symptoms. Indirect laryngoscopy by an ENT specialist was mandatory before surgery and before discharge. In patients with RLN paresis, an additional examination was scheduled at 2 weeks and 1, 2, 4, 6, and 12 months after surgery, or until the vocal cord function recovered. Vocal cord paresis for more than 12 months after the operation was regarded as permanent palsy.