Complications of thyroid surgery: Analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years

被引:606
作者
Rosato, L
Avenia, N
Bernante, P
De Palma, M
Gulino, G
Nasi, PG
Pelizzo, MR
Pezzullo, L
机构
[1] Ivrea Hosp, Dept Surg, Endocrine Surg Unit, I-10015 Ivrea, Italy
[2] Univ Perugia, Dept Surg, Endocrine Surg Unit, I-06100 Perugia, Italy
[3] Univ Padua, Dept Surg, Endocrine Surg Unit, I-35128 Padua, Italy
[4] Cardarelli Hosp, Dept Surg, Endocrine Surg Unit, I-80131 Naples, Italy
[5] Ivrea Hosp, Epidemiol Clin Med Dept Off, I-10015 Ivrea, Italy
[6] Umberto I Mauriziano Hosp, Dept Surg, Endocrine Surg Unit, I-10129 Turin, Italy
[7] INT Pascale Hosp, Dept Surg, Endocrine Surg Unit, I-80132 Naples, Italy
关键词
D O I
10.1007/s00268-003-6903-1
中图分类号
R61 [外科手术学];
学科分类号
摘要
Complication rates associated with thyroid surgery can be evaluated only through analysis of case studies and follow-up data. This study covers postoperative data from 14,934 patients subjected to a follow-up of 5 years. Among them, 3130 (20.9%) underwent total lobectomy (TL), 9599 (64.3%) total thyroidectomy (TT), 1448 (9.7%) subtotal thyroidectomy with a monolateral remnant (MRST), and 757 (5.1%) subtotal thyroidectomy with bilateral remnants (BRST). A total of 6% of the patients had already been operated on. Persistent hypoparathyroidism occurred after 1.7% of all the operations, and temporary hypoparathyroidism was noted in 8.3%. Permanent palsy of the laryngeal recurrent nerve (LRN) occurred in 1.0% of patients. transient palsy in 2.0%, and diplegia in 0.4%. The superior laryngeal nerve was damaged in 3.7%; dysphagia occurred in 1.4% of eases, hemorrhage in 1.2%, and wound infection in 0.3%. No deaths were reported. A significant rate of LRN damage was noted, which has an important impact on the patient's social life. Hypoparathyroidism after total thyroidectomy is an important complication that can be successfully treated by therapy, although it is not always easily managed in special circumstances such as in young persons or pregnant women. The complications associated with thyroid surgery must be kept in mind so the surgeon can carefully evaluate the surgical and medical therapeutic options, have more precise surgical indications, and be able to give the patient adequate information.
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页码:271 / 276
页数:6
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