Mishra A, Agarwal A, Agarwal G, Mishra S K
Department of Endocrine Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226 014, UP, India.
World J Surg. 2001 Mar;25(3):307-10. doi: 10.1007/s002680020100.
Total thyroidectomy is increasingly being accepted as a treatment of choice for differentiated thyroid cancer. However, because of presumed increased morbidity associated with this procedure, it is still not considered a viable option for management of benign thyroid disorders. To assess the safety and efficacy of total thyroidectomy for management of benign thyroid disorders, we analyzed our data from 127 total thyroidectomies performed for benign thyroid disorders. Demographic details, biochemical findings, indications for operation, specimen weight, and complications were noted. Among these patients, 52 had a toxic goiter and 75 had a nontoxic goiter. The mean duration of the goiters being present was 6.08 +/- 6.06 years (0.9--26.0 years), and the mean weight of the specimens was 136.88 +/- 120.68 g. The incidence of occult malignancy was 6.3% (n = 8), and those of permanent hypothyroidism and permanent recurrent laryngeal nerve palsy were 1.6% and 0.8%, respectively. Total thyroidectomy should be considered a treatment of choice for multinodular goiter and Graves' disease in a setting of palpable nodule(s) or ophthalmopathy (or both). It is particularly relevant in endemic regions where patients present with a long-standing, large nodular goiter with virtually no normal thyroid tissue. Reoperation for recurrent goiter in such a setting would be fraught with distressing complications.
全甲状腺切除术越来越被认为是分化型甲状腺癌的首选治疗方法。然而，由于推测该手术的发病率会增加，它仍然不被视为治疗良性甲状腺疾病的可行选择。为了评估全甲状腺切除术治疗良性甲状腺疾病的安全性和有效性，我们分析了127例因良性甲状腺疾病行全甲状腺切除术的患者数据。记录了人口统计学细节、生化检查结果、手术指征、标本重量和并发症。在这些患者中，52例患有毒性甲状腺肿，75例患有非毒性甲状腺肿。甲状腺肿的平均存在时间为6.08±6.06年（0.9 - 26.0年），标本的平均重量为136.88±120.68克。隐匿性恶性肿瘤的发生率为6.3%（n = 8），永久性甲状腺功能减退和永久性喉返神经麻痹的发生率分别为1.6%和0.8%。在存在可触及结节或眼病（或两者皆有）的情况下，全甲状腺切除术应被视为多结节性甲状腺肿和格雷夫斯病的首选治疗方法。在地方性甲状腺肿流行地区，这一点尤为重要，因为这些地区的患者患有长期、巨大的结节性甲状腺肿，几乎没有正常甲状腺组织。在这种情况下，对复发性甲状腺肿进行再次手术会充满令人痛苦的并发症。
