Naan Elaine C, Kirpensteijn Jolle, Kooistra Hans S, Peeters Marijke E
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
Vet Surg. 2006 Apr;35(3):287-93. doi: 10.1111/j.1532-950X.2006.00146.x.
To describe outcome after thyroidectomy in hyperthyroid cats, with emphasis on peri- and postsurgical complications and recurrence.
Retrospective study.
One hundred and one hyperthyroid cats.
Diagnostic work-up included preoperative measurement of plasma calcium, sodium, potassium, urea, and creatinine concentrations, and thyroid scintigraphy. A modified intracapsular dissection technique was performed. Postoperatively, parathyroid gland function was evaluated by measuring plasma calcium concentration several times daily. Outcome was obtained by standard telephone questionnaire.
Thyroid scintigraphy revealed ectopic hyperplastic thyroid tissue (EHTT) in 9 cats. Preoperatively, 29 of 91 cats had hypokalemia. Two cats died within 3 days after surgery and 5 of 86 cats developed postoperative transient hypocalcemia. On histologic examination, thyroid carcinoma was identified in 3 of 88 cats. Hyperthyroidism recurred in 5 cats between 3 and 59 months; 4 of these cats had EHTT preoperatively. The difference in recurrence rate between hyperthyroid cats with and without EHTT was significant (P<.001).
Complications were uncommon after thyroidectomy performed by an experienced surgeon when combined with an anesthetic regimen associated with minimal adverse cardiovascular effects. Hyperthyroid cats with EHTT had a significantly higher chance of recurrence.
Thyroidectomy is associated with a low incidence of surgical complications and is an effective treatment for hyperthyroid cats when radioactive iodine therapy is not available. Preoperative thyroid scintigraphy is advised. Surgery is not recommended when EHTT is present, because of a higher chance of developing recurrent disease.
描述甲状腺功能亢进猫甲状腺切除术后的结果,重点关注围手术期和术后并发症及复发情况。
回顾性研究。
101只甲状腺功能亢进猫。
诊断性检查包括术前测定血浆钙、钠、钾、尿素和肌酐浓度,以及甲状腺闪烁扫描。采用改良的囊内剥离技术。术后,通过每日多次测量血浆钙浓度评估甲状旁腺功能。通过标准电话问卷获取结果。
甲状腺闪烁扫描显示9只猫存在异位增生性甲状腺组织(EHTT)。术前,91只猫中有29只患有低钾血症。2只猫在术后3天内死亡,86只猫中有5只出现术后短暂性低钙血症。组织学检查发现,88只猫中有3只患有甲状腺癌。5只猫在术后3至59个月复发甲状腺功能亢进;其中4只猫术前有EHTT。有EHTT和无EHTT的甲状腺功能亢进猫的复发率差异有统计学意义(P<0.001)。
由经验丰富的外科医生进行甲状腺切除术,并结合对心血管系统不良影响最小的麻醉方案时,并发症并不常见。有EHTT的甲状腺功能亢进猫复发几率显著更高。
甲状腺切除术手术并发症发生率低,在无法进行放射性碘治疗时是治疗甲状腺功能亢进猫的有效方法。建议术前进行甲状腺闪烁扫描。当存在EHTT时不建议手术,因为复发疾病的几率更高。