Department of Surgery, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada.
Am J Surg. 2011 May;201(5):570-4. doi: 10.1016/j.amjsurg.2010.12.006.
Recent recommendations suggest that total thyroidectomy (TT) is the preferred treatment for benign thyroid disease. This approach remains controversial because of the increased risk of morbidity compared with a partial thyroidectomy (PT). The aim of this study was to determine the use of thyroidectomy for benign disease over a 15-year period.
One hundred nineteen thousand eight hundred eighty-five patients from the Nationwide Inpatient Sample database (1993-2007) underwent surgery for benign thyroid disease. Logistic regression was used to assess the relation between extent of thyroidectomy and the year of admission, hospital volume, and surgical outcomes.
The use of TT increased from 17.6% (1993-1997) to 39.6% (2003-2007) compared with 82.4% and 60.4% for PT over the same periods (P < .0001). A greater proportion of TTs was performed in high-volume centers in which the rates of postoperative complications were lower than low-volume centers.
The use of TT for benign thyroid disease has increased over the last 15 years in the United States. This pattern of practice is in keeping with the trends reported in recent literature.
最近的建议表明，甲状腺全切除术（TT）是治疗良性甲状腺疾病的首选方法。与甲状腺部分切除术（PT）相比，这种方法增加了发病率的风险，因此仍然存在争议。本研究旨在确定在 15 年期间对良性疾病进行甲状腺切除术的应用情况。
国家住院患者样本数据库（1993-2007 年）中的 119885 名患者因良性甲状腺疾病接受了手术。使用逻辑回归评估甲状腺切除术的范围与入院年份、医院量和手术结果之间的关系。
与同期的 82.4%和 60.4%相比，TT 的使用从 1993-1997 年的 17.6%增加到 2003-2007 年的 39.6%，而同期 PT 的使用分别为 82.4%和 60.4%（P <.0001）。在高容量中心中进行的 TT 比例更高，术后并发症的发生率低于低容量中心。
在美国，过去 15 年来，治疗良性甲状腺疾病的 TT 使用率有所增加。这种实践模式与最近文献中报告的趋势一致。
