Acun Zeki, Comert Mustafa, Cihan Alper, Ulukent Suat Can, Ucan Bulent, Cakmak Guldeniz Karadeniz
General Surgery Department, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.
Arch Surg. 2004 Apr;139(4):444-7; discussion 447. doi: 10.1001/archsurg.139.4.444.
Near-total thyroidectomy, on the basis of its low morbidity rate, is an appropriate treatment option in the surgical management of various thyroid diseases in an endemic region in Turkey.
Single-institution study of patients with various thyroid diseases treated by means of near-total thyroidectomy within 2 years in an endemic region, with comparison of the results vs the complication rates of bilateral subtotal and total thyroidectomy reported in the literature.
Tertiary academic referral center.
One hundred fifty-two patients who underwent near-total thyroidectomy for various thyroid diseases.
Surgical treatments of various benign thyroid diseases were compared according to the complication rates and the achievable benefits of the procedures.
In our clinic, near-total thyroidectomy was the principal surgical procedure performed for benign thyroid disease. The temporary recurrent laryngeal nerve palsy rate with respect to the nerves at risk was 3.3% (10 of 304 nerves), whereas temporary hypoparathyroidism was 7.2% (11 of 152 patients). Neither permanent recurrent laryngeal nerve palsy nor permanent hypoparathyroidism occurred. In 1 patient, wound hematoma developed and required re-exploration. Seroma in another patient needed no medical or surgical intervention. Neither wound infection nor mortality were noted.
Near-total thyroidectomy achieves a lower complication rate of hypoparathyroidism and a similar complication rate of recurrent laryngeal nerve palsy and recurrence when compared with the rates reported in the literature for total thyroidectomy. It is an effective and safe surgical treatment option for various benign thyroid diseases.
鉴于其低发病率，近全甲状腺切除术是土耳其某流行地区各种甲状腺疾病外科治疗的合适选择。
对某流行地区在2年内接受近全甲状腺切除术治疗的各种甲状腺疾病患者进行单机构研究，并将结果与文献报道的双侧次全甲状腺切除术和全甲状腺切除术的并发症发生率进行比较。
三级学术转诊中心。
152例因各种甲状腺疾病接受近全甲状腺切除术的患者。
根据并发症发生率和手术可获得的益处，比较各种良性甲状腺疾病的手术治疗方法。
在我们的诊所，近全甲状腺切除术是治疗良性甲状腺疾病的主要手术方法。相对于有风险的神经，暂时性喉返神经麻痹发生率为3.3%（304条神经中有10条），而暂时性甲状旁腺功能减退发生率为7.2%（152例患者中有11例）。未发生永久性喉返神经麻痹和永久性甲状旁腺功能减退。1例患者出现伤口血肿，需要再次手术探查。另1例患者的血清肿无需药物或手术干预。未发现伤口感染和死亡病例。
与文献报道的全甲状腺切除术相比，近全甲状腺切除术的甲状旁腺功能减退并发症发生率较低，喉返神经麻痹和复发的并发症发生率相似。它是各种良性甲状腺疾病有效且安全的手术治疗选择。
