The extrafascial method of operation was used because of high risk of malignization of nodular endemic goiters. The extrafascial hemithyroidectomy with an isthmus is considered by the authors to be the major and minimum operation volume in patients with nodular goiters. The method was used in 76,8% of the patients. In patients with thyroid carcinoma the operation of this volume was fulfilled in 66,5% of cases.