Gonçalves Filho João, Kowalski Luiz Paulo
Head and Neck Surgery and Otorhinolaryngology Department, Centro de Tratamento e Pesquisa Hospital do Câncer A C Camargo, São Paulo, Brazil.
Otolaryngol Head Neck Surg. 2005 Mar;132(3):490-4. doi: 10.1016/j.otohns.2004.09.028.
This study evaluates the incidence and risk factors of complications in patients submitted to thyroidectomy in a cancer hospital with residency training.
A retrospective chart and complications review of 1020 patients (1990-2000) underwent to thyroidectomy.
At our cancer hospital, 1020 patients underwent thyroidectomy. The main postoperative complications consisted of transient hypocalcemia in 134 (13.1%) patients, permanent hypocalcemia in 26 (2.5%) patients, transient vocal cord palsy in 14 (1.4%) patients, and permanent vocal cord palsy in 4 (0.4%) patients. The type of thyroidectomy, neck dissection, and paratracheal lymph node dissection were significantly associated with transitory and permanent hypocalcemia.
Thyroid surgery can be performed safely in a surgical residency training program under direct supervision of an experienced surgeon with little morbidity to the patients. Hypocalcemia is the most significant complication. Neck and paratracheal lymph node dissections were the most significant predictors of hypocalcemia in patients who underwent total thyroidectomy.
本研究评估在一家有住院医师培训的癌症医院接受甲状腺切除术患者的并发症发生率及危险因素。
对1020例(1990 - 2000年)接受甲状腺切除术的患者进行回顾性病历及并发症审查。
在我们的癌症医院,1020例患者接受了甲状腺切除术。主要术后并发症包括134例(13.1%)患者出现短暂性低钙血症,26例(2.5%)患者出现永久性低钙血症,14例(1.4%)患者出现短暂性声带麻痹,4例(0.4%)患者出现永久性声带麻痹。甲状腺切除术的类型、颈部清扫术及气管旁淋巴结清扫术与短暂性和永久性低钙血症显著相关。
在经验丰富的外科医生直接监督下的外科住院医师培训项目中,甲状腺手术可以安全进行,对患者的发病率较低。低钙血症是最主要的并发症。颈部及气管旁淋巴结清扫术是接受全甲状腺切除术患者发生低钙血症的最重要预测因素。