When a total thyroidectomy is required according to the guidelines and the patient’s condition, but the parathyroid glands are not well preserved and only a few glands can be preserved, it is recorded as a total resection, which is in fact at best a subtotal resection or “pseudo-total resection”. Sometimes it is explained that this is for your own good, or there will be serious complications, but in fact, it is still a failure to preserve the parathyroid glands. Seeing some thyroid cancer patients to perform total thyroidectomy cases after surgery and then ultrasound examination found that obviously retain a considerable volume and weight of the thyroid gland, and even residual half of the gland, that is to say, the use of sub-total resection of the thyroid gland or partial resection, but the medical records of the surgical record is written as a total thyroidectomy, let’s just call it “pseudo-total resection”. “So, the reason for this is not clear, guessing that probably recognize the thyroid cancer should be used to cut the whole but the technology can not reach, for fear of serious complications and seek its “secondary” results. Perhaps there is a lack of knowledge and technical mastery of total excision and subtotal excision. Then how to know whether it is pseudo-total excision? From the postoperative iodine 131 “clear nail” dose can be accurately seen, the so-called clear nail, that is, with iodine 131 to remove the residual after surgery residual invisible to the naked eye residual thyroid tissue, if the dose of clear nail is 30, 60 mcg, that is, the resection of a very clean, if 100 or 120 mcg or even two 100 mcg to remove, or acceptable, but if 2, 60 mcg, or even two 100 mcg to remove, or can be used. If 100 or 120 milligrams or even 2 times 100 milligrams to clear, it is still acceptable, but if after 2 or 3 times of iodine 131 has not cleared, it is probably a pseudo-total excision, because the human body can withstand the extreme amount of iodine 131 500-600 milligrams, and further increase in the dose has no therapeutic significance, but only increase the damage to the human body. If 300-400 of the 500 mcg are used to remove normal thyroid tissue, how much more can be done to kill cancer cells? What is the point of this treatment, so a responsible isotope doctor will ask the patient to undergo another surgery to remove the excess thyroid gland because of the excess thyroid gland residue.