Dener Cenap
Department ol Surgery, Fatih University School of Medicine, Ankara, Turkey.
Acta Otolaryngol. 2002 Sep;122(6):679-83. doi: 10.1080/000164802320396394.
Controversy persists concerning the use of total thyroidectomy in benign thyroid disease and varying complication rates have been reported. We evaluated the safety of total thyroidectomy or lobectomy in benign thyroid disease. During a 5-year period, 102 patients were operated on for benign thyroid disease, including multinodular goiter (n = 55), solitary nodule (n = 18), toxic nodular goiter (n = 22) and Hashimoto's thyroiditis (n = 7). Recurrent laryngeal nerves were routinely investigated during dissection. Total thyroidectomy was performed in 27 cases, unilateral total lobectomy with isthmectomy in 38 and unilateral total, contralateral subtotal lobectomy in 37. One (0.9%) temporary superior laryngeal nerve palsy, 1 (0.9%) temporary recurrent nerve palsy and 1 (0.9%) temporary hypoparathyroidism occurred. Wound seroma developed in 2 patients (1.9%). There were no deaths or permanent complications. This study shows that total thyroidectomy or lobectomy can be done with minimal morbidity in cases of benign thyroid disease affecting the whole gland.
关于在良性甲状腺疾病中使用全甲状腺切除术仍存在争议,并且已有不同的并发症发生率报道。我们评估了全甲状腺切除术或甲状腺叶切除术在良性甲状腺疾病中的安全性。在5年期间,102例患者接受了良性甲状腺疾病手术,包括多结节性甲状腺肿(n = 55)、孤立性结节(n = 18)、毒性结节性甲状腺肿(n = 22)和桥本甲状腺炎(n = 7)。在解剖过程中常规检查喉返神经。27例行全甲状腺切除术,38例行单侧全叶切除加峡部切除术,37例行单侧全叶、对侧次全叶切除术。发生1例(0.9%)暂时性喉上神经麻痹、1例(0.9%)暂时性喉返神经麻痹和1例(0.9%)暂时性甲状旁腺功能减退。2例患者(1.9%)出现切口血清肿。无死亡病例或永久性并发症。本研究表明,在影响整个腺体的良性甲状腺疾病病例中,全甲状腺切除术或甲状腺叶切除术可在最低发病率的情况下进行。