Complications in thyroid resurgery: a single institutional experience on 233 patients from a whole series of 4,752 homogeneously treated patients

被引:20
作者
Pelizzo, M. R. [1 ]
Variolo, M. [1 ]
Bernardi, C. [1 ]
Izuzquiza, M. [1 ]
Piotto, A. [1 ]
Grassetto, G. [2 ]
Colletti, P. M. [3 ]
Boschin, I. Merante [1 ]
Rubello, D. [2 ,4 ]
机构
[1] Univ Padua, Surg Clin 2, Dept Surg Oncol & Gastroenterol Sci, Padua, Italy
[2] Santa Maria della Misericordia Hosp, Dept Nucl Med, Rovigo, Italy
[3] Univ So Calif, Dept Radiol, Los Angeles, CA USA
[4] Univ Padua, Dept Imaging, Clin Lab, Biotechnol Lab, Padua, Italy
关键词
Thyroid surgery; Benign diseases; Malignant diseases; Intraoperative complications; Resurgery; COMPLETION THYROIDECTOMY; REOPERATIVE SURGERY; MORBIDITY; CANCER; GOITER;
D O I
10.1007/s12020-014-0225-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to examine a homogeneous, consecutive recent series of patients who underwent reoperation on the thyroid bed to assess the incidence of the complications commonly correlated with resurgery. We reviewed clinical charts of 233 patients who underwent resurgery taken from a total of 4,752 patients previously operated on for benign and malignant thyroid diseases from 2006 to 2010 by the same surgical team. We evaluated the incidence of postoperative hemorrhage, hypoparathyroidism, and recurrent laryngeal nerve (RLN) palsy. Analyses were done separately in relation to the type of the type of resurgery adopted: (A) monolateral completion; (B) bilateral completion, after monolateral (B1) or bilateral prior surgery (B2); and (C) lymph node dissection. We also separately analyzed patients according to their final histological diagnosis of benign or malignant disease. Regarding hemorrhage, 6/233 patients (2.5 %) underwent surgical revision of the thyroid within 12 h for postoperative hemorrhage. They included 2 (1.5 %) of the 129 monolateral reoperations (A), 3 (4 %) of the 74 bilateral reoperations (B), and 1 (3.3 %) of the 30 central dissections for nodal relapse (C). Transient and definitive postoperative hypoparathyroidism was recorded in 78 (36.4 %) and 7 (3.3 %) of the 214 eligible patients. Transient RLN palsy occurred in 21 RLNs at risk (7 %) and definitive RLN palsy in 5 (1.7 %). Elective total thyroidectomy cannot always be supported as an effective policy for preventing recurrences in patients with a single, benign node: lobectomy, preferably with extemporaneous histological examination, unquestionably represents the best minimal approach to thyroid resection.
引用
收藏
页码:100 / 106
页数:7
相关论文
共 25 条
[1]  
BEAHRS OH, 1963, SURG GYNECOL OBSTET, V117, P535
[2]   Non-surgical approach to the benign nodular goiter: new opportunities by recombinant human TSH-stimulated 131I-therapy [J].
Bonnema, Steen Joop ;
Fast, Soren ;
Hegedus, Laszlo .
ENDOCRINE, 2011, 40 (03) :344-353
[3]   MORBIDITY OF COMPLETION THYROIDECTOMY FOR INITIALLY MISDIAGNOSED THYROID-CARCINOMA [J].
CALABRO, S ;
AUGUSTE, LJ ;
ATTIE, JN .
HEAD & NECK SURGERY, 1988, 10 (04) :235-238
[4]  
Calo Pietro Giorgio, 2009, Chir Ital, V61, P545
[5]   Reoperative thyroid surgery [J].
Chao, TC ;
Jeng, LB ;
Lin, JD ;
Chen, MF .
WORLD JOURNAL OF SURGERY, 1997, 21 (06) :644-647
[6]  
Costamagna D, 2013, G CHIR, V34, P21
[7]   The advantage of total thyroidectomy to avoid reoperation for incidental thyroid cancer in multinodular goiter [J].
Giles, Y ;
Boztepe, H ;
Terzioglu, T ;
Tezelman, S .
ARCHIVES OF SURGERY, 2004, 139 (02) :179-182
[8]   Long-term outcome after radioiodine therapy with adjuvant rhTSH treatment: comparison between patients with non-toxic and pre-toxic large multinodular goitre [J].
Giusti, M. ;
Caorsi, V. ;
Mortara, L. ;
Caputo, M. ;
Monti, E. ;
Schiavo, M. ;
Bagnara, M. C. ;
Minuto, F. ;
Bagnasco, M. .
ENDOCRINE, 2014, 45 (02) :221-229
[9]   Surgical approaches to thyroid tumors [J].
Gosnell, Jessica E. ;
Clark, Orlo H. .
ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA, 2008, 37 (02) :437-+
[10]  
Inabnet WB, 2013, J AM COLL SURGEONS, V216, P577