Current Practice of Surgery for Benign GoitreAn Analysis of the Prospective DGAV StuDoQ|Thyroid Registry

被引：47

作者：

Bartsch, Detlef K. ^{[1
]}

Dotzenrath, Cornelia ^{[2
]}

Vorlaender, Christian ^{[3
]}

Zielke, Andreas ^{[4
]}

Weber, Theresia ^{[5
]}

Buhr, Heinz J. ^{[6
]}

Klinger, Carsten ^{[6
]}

Lorenz, Kerstin ^{[7
]}

Freitag, Christian ^{[8
]}

Krenz, Detlef ^{[9
]}

Buechler, Markus Wolfgang ^{[10
]}

Klozoris, Stefan ^{[11
]}

Saalabian, Said ^{[12
]}

Memming, Martin ^{[13
]}

Koehler, Hinrich ^{[14
]}

Germer, Christoph-Thomas ^{[15
]}

Steigemann, Nikolaus ^{[16
]}

Jaehne, Joachim ^{[17
]}

Boettcher, Knut A. ^{[18
]}

Bruetting, Alfred ^{[19
]}

Zieren, Hans Udo ^{[20
]}

Weih, Heimo ^{[21
]}

Pistorius, Georg ^{[22
]}

Heise, Michael ^{[23
]}

Schwab, Robert ^{[24
]}

Schwarz, Katharina ^{[25
]}

Kasperk, Reinhard ^{[26
]}

Langer, Peter ^{[27
]}

Kemen, Matthias ^{[28
]}

Mirow, Lutz ^{[29
]}

Behrend, Matthias ^{[30
]}

Schwarz, Michael ^{[31
]}

Beuleke, Andrea ^{[32
]}

Loehnert, Mathias ^{[33
]}

Hoffmann, Matthias ^{[34
]}

Nies, Christoph ^{[35
]}

Hagel, Christopher ^{[36
]}

Tigges, Harald ^{[37
]}

Krings, Friedrich ^{[38
]}

Schabram, Jochen ^{[39
]}

Jacobi, Christoph-Andreas ^{[40
]}

Schuld, Jochen ^{[41
]}

Moench, Christian ^{[42
]}

Ghadimi, Michael ^{[43
]}

Prinz, Christoph ^{[44
]}

Train, Stefan ^{[45
]}

Ridwelski, Karsten ^{[46
]}

Heuser, Matthias ^{[47
]}

Mellert, Joachim ^{[48
]}

Simon, Thomas ^{[49
]}

机构：

[1] Philipps Univ Marburg, Dept Visceral Thoracic & Vasc Surg, D-35043 Marburg, Germany

[2] Helios Univ Hosp Wuppertal, Dept Endocrine Surg, D-42283 Wuppertal, Germany

[3] Burgerhosp Frankfurt Main, Dept Gen & Endocrine Surg, D-60318 Frankfurt, Germany

[4] Diakonie Klinikum Stuttgart, Dept Endocrine Surg, D-70176 Stuttgart, Germany

[5] Katholisches Klinikum Mainz, Dept Endocrine Surg, D-55131 Mainz, Germany

[6] German Soc Gen & Visceral Surg DGAV, D-10117 Berlin, Germany

[7] Univ Med Ctr Halle, Dept Visceral Vasc & Endocrine Surg, D-06120 Halle, Germany

[8] Krankenhaus St Joseph Stift Dresden, Chirurg Klin, Dresden, Germany

[9] Klinikum Dritter Orden Munchen, Klin Allgemein Viszeral Gefass & Thoraxchirurg, Munich, Germany

[10] Krankenhaus Salem Heidelberg & Krankenhaus Sinshe, Chirurg Klin, Sinsheim, Germany

[11] Evangelisches Johanniter Krankenhaus Bonn, Klin Allgemein & Viszeralchirurg, Bonn, Germany

[12] DKD Wiesbaden, Klin Endokrine Chirurg, Wiesbaden, Germany

[13] Klinikum Robert Koch Gehrden, Klin Allgemein Viszeral & Gefasschirurg, Gehrden, Germany

[14] Herzogin Elisabeth Hosp Braunschweig, Chirurg Klin, Braunschweig, Germany

[15] Univ Klinikum Wurzburg, Klin Allgemein Viszeral Gefass & Kinderchirurg, Wurzburg, Germany

[16] Klin Endokrine Chirurg Krankenhaus Vilsiburg, Vilsbiburg, Germany

[17] Diakonie Krankenhaus Henriettenstiftung Hannover, Klin Allgemein & Viszeralchirurg, Hannover, Germany

[18] Diakoniekrankenhaus Mannheim, Abt Allgemein & Viszeralchirurg, Mannheim, Germany

[19] Maltester Waldkrankenhaus St Marien Erlangen, Chirurg Klin, Erlangen, Germany

[20] St Agatha Krankenhaus Koln, Klin Allgemein Viszeral & Unfallchirurg, Cologne, Germany

[21] Asklepios Klin Seligenstadt, Klin Allgemein & Viszeralchirurg, Seligenstadt, Germany

[22] Klinikum Landkreises Bamberg, Klin Allgemein & Viszeralchirurg, Bamberg, Germany

[23] Sana Klinikum Lichtenberg, Klin Allgemein & Viszeralchirurg, Berlin, Germany

[24] Bundeswehrkrankenhaus Koblenz, Klin Allgemein Viszeral & Thoraxchirurg, Koblenz, Germany

[25] Lukaskrankenhaus Neuss, Chirurg Klin 3, Neuss, Germany

[26] Luisenhospital Aachen, Klin Allgemein Viszeral & Thoraxchirurg, Aachen, Germany

[27] Klinikum Hanau, Klin Allgemein Viszeral & Thoraxchirurg, Hanau, Germany

[28] Evangelisches Krankenhaus Herne, Klin Allgemein & Viszeralchirurg, Herne, Germany

[29] Klinikum Chemnitz, Klin Allgemein & Viszeralchirurg, Chemnitz, Germany

[30] Donau Isar Klinikum Deggendorf, Klin Viszeral Thorax & Gefasschirurg, Deggendorf, Germany

[31] Schilddrusenzentrum Neu Ulm, GPS, Zentrum Onkolog Endokrine & Minimal Invas Chirurg, Ulm, Germany

[32] Klinikum Grosswedel, Klin Allgemein & Viszeralchirurg, Burgwedel, Germany

[33] Klinikum Bielefeld, Klin Allgemein & Viszeralchirurg, Bielefeld, Germany

[34] Raphaelsklin Munster, Klin Allgemein & Viszeralchirurg Sekt Proktol, Munster, Germany

[35] Niels Stensen Klinikum Marienhosp Osnabruck, Klin Klin Allgemein & Viszeralchirurg, Osnabruck, Germany

[36] Marienhausklinikum Saarlouis Dillingen, Klin Allgemein & Viszeralchirurg, Saarlouis, Germany

[37] Klinikum Landsberg Lech, Klin Allgemein Viszeral & Gefasschirurg, Landsberg Am Lech, Germany

[38] Christophorus Kliniken Coesfeld, Chirurg Klin 1, Coesfeld, Germany

[39] Asklepios Klin Lich, Klin Endokrine Chirurg, Lich, Germany

[40] Dreifaltigkeit Krankenhaus Wesseling, Chirurg Klin, Wesseling, Germany

[41] Knappschaftskrankenhaus Sulzbach, Klin Allgemein & Viszeralchirurg, Sulzbach, Germany

[42] Westpfalz Klinikum Kaiserslautern, Klin Allgemein Viszeral & Transplantat Chirurg, Kaiserslautern, Germany

[43] Univ Med Gottingen, Klin Allgemein Viszeral & Kinderchirurg, Gottingen, Germany

[44] KMG Klinikum Gustrow GmbH, Klin Allgemein Thorax & Gefasschirurg, Gustrow, Germany

[45] Johanniter Krankenhaus Gronau, Klin Allgemein & Viszeralchirurg, Gronau, Germany

[46] Klinikum Magdeburg gGmbH, Klin Allgemein & Viszeralchirurg, Magdeburg, Germany

[47] St Elisabeth Hosp Herten, Klin Allgemein & Viszeralchirurg, Herten, Germany

[48] St Ansgar Krankenhaus Hoxter, Klin Allgemein Viszeral & Gefasschirurg, Hoxter, Germany

[49] GRN Klin Weinheim, Klin Allgemein & Viszeralchirurg, Weinheim, Germany

[50] Stadt Klinikum Wolfenbuttel, Klin Allgemein Viszeral, Wolfenbuttel, Germany

来源：

JOURNAL OF CLINICAL MEDICINE | 2019年 / 8卷 / 04期

关键词：

indication; thyroid resection; registry; recurrent laryngeal nerve palsy; hypoparathyroidism; SURGICAL-MANAGEMENT; GOITER; COMPLICATIONS; ASSOCIATION; GUIDELINES; OPERATIONS; PARALYSIS; RESECTION; GERMANY; NODULES;

D O I：

10.3390/jcm8040477

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: To evaluate the current indications, resection strategies and short-term outcomes of surgery for benign goitre in a country with endemic goitre. Methods: Data of patients who underwent surgery for benign goitre were retrieved from the prospective StuDoQ/Thyroid registry and retrospectively analysed regarding the patient's demographics, indications for surgery, surgical procedures, histology, and perioperative outcomes. Results: In a 15-month period, 12,888 patients from 83 departments underwent thyroid resections for benign conditions. Main indications for surgery were exclusion of malignancy (68%), compression symptoms (20.7%) and hyperthyroidism (9.7%). Preoperative fine needle aspiration cytology was performed in only 12.2% of patients with the indication exclusion of malignancy. Thyroidectomy (49.8%) or hemithyroidectomy (36.9%) were performed in 86.7% of patients. Minimally invasive or alternative surgical techniques were applied in only 2.2%. Intraoperative neuromonitoring was used in 98.4% of procedures, in 97.5% of patients at least one parathyroid gland was visualized, and in 15.3% of patients parathyroid tissue was autografted, respectively. The rates of unilateral and bilateral transient recurrent nerve palsy were 3.6% and 0.07% of nerves at risk, the rate of transitory hypoparathyroidism was 15.3%. The rates of postoperative bleeding and wound infections requiring reoperation were 1.4% and 0.07%, respectively. Conclusions: The indication exclusion of malignancy is made too liberally, and there is a strong attitude to perform complete thyroid resections. Postoperative hypoparathyroidism is the major complication after surgery for benign thyroid disease, thus requiring more awareness.

引用

页数：10

共 22 条

[1]

[Anonymous], 2016, NUKLEARMEDIZINER, DOI DOI 10.1055/s-0042-102530

[2]

[Anonymous], STAT BUND FALLP KRAN

[3] Indications for the Surgical Management of Benign Goiter in Adults [J].

Bartsch, Detlef K. ;

Luster, Markus ;

Buhr, Heinz J. ;

Lorenz, Dietmar ;

Germer, Christoph-Thomas ;

Goretzki, Peter E. .

DEUTSCHES ARZTEBLATT INTERNATIONAL, 2018, 115 (1-2) :1-+

[4] Complications to thyroid surgery:: results as reported in a database from a multicenter audit comprising 3,660 patients [J].

Bergenfelz, A. ;

Jansson, S. ;

Kristoffersson, A. ;

Martensson, H. ;

Reihner, E. ;

Wallin, G. ;

Lausen, I. .

LANGENBECKS ARCHIVES OF SURGERY, 2008, 393 (05) :667-673

[5] Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr) [J].

Blanchard, C. ;

Pattou, F. ;

Brunaud, L. ;

Hamy, A. ;

Dahan, M. ;

Mathonnet, M. ;

Volteau, C. ;

Caillard, C. ;

Durand-Zaleski, I. ;

Mirallie, E. .

BJS OPEN, 2017, 1 (01) :2-10

[6] Laryngeal neuromonitoring and neurostimulation versus neurostimulation alone in thyroid surgery: A randomized clinical trial [J].

Cavicchi, Ottavio ;

Caliceti, Umberto ;

Fernandez, Ignacio Javier ;

Ceroni, Alberto Rinaldi ;

Marcantoni, Alessandra ;

Sciascia, Silvia ;

Sottili, Sandra ;

Piccin, Ottavio .

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2012, 34 (02) :141-145

[7] The Bethesda System for Reporting Thyroid Cytopathology [J].

Cibas, Edmund S. ;

Ali, Syed Z. .

AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 2009, 132 (05) :658-665

[8] Vascular clips versus ligatures in thyroid surgery-results of a multicenter randomized controlled trial (CLIVIT Trial) [J].

Diener, Markus K. ;

Seiler, Christoph M. ;

von Frankenberg, Moritz ;

Rendel, Kathleen ;

Schuele, Silke ;

Maschuw, Katja ;

Riedl, Stefan ;

Rueckert, Jens C. ;

Eckmann, Christian ;

Scharlau, Uwe ;

Ulrich, Alexis ;

Bruckner, Thomas ;

Knaebel, Hanns-Peter ;

Rothmund, Matthias ;

Buechler, Markus W. .

LANGENBECKS ARCHIVES OF SURGERY, 2012, 397 (07) :1117-1126

[9]

Dralle H, 2014, CHIRURG, V85, P236, DOI 10.1007/s00104-013-2705-7

[10] Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery [J].

Dralle, H ;

Sekulla, C ;

Haerting, J ;

Timmermann, W ;

Neumann, HJ ;

Kruse, E ;

Grond, S ;

Mühlig, HP ;

Richter, C ;

Voss, J ;

Thomusch, O ;

Lippert, H ;

Gastinger, I ;

Brauckhoff, M ;

Gimm, O .

SURGERY, 2004, 136 (06) :1310-1321

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