Abboud Bassam, Sleilaty Ghassan, Tannoury Jenny, Daher Ronald, Abadjian Gerard, Ghorra Claude
Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Am Surg. 2011 Dec;77(12):1624-8.
This study aims to review the safety of thyroidectomy combined with cervical neck dissection without drainage in well-differentiated thyroid carcinoma (WDTC). The medical records of consecutive patients who underwent thyroidectomy without drainage for WDTC were retrospectively reviewed. Group 1 included 123 patients who underwent thyroidectomy with central neck dissection and Group 2 included 46 patients who underwent thyroidectomy with central and lateral neck dissection. One hundred twenty-seven patients underwent thyroidectomy without neck dissection and were included in Group 3. Overall, 16 patients (5%) developed postoperative hematoma and/or seroma, seven patients (6%) in the Group 1, three patients (7%) in the Group 2, and six patients (5%) in Group 3. All patients had minor bleeding or seroma not requiring surgical intervention. Overall, 68 patients (23%) had transient postoperative hypocalcaemia, and four patients(1%) had permanent hypoparathyroidism. Seventeen patients (6%) had transient postoperative hoarseness and three had permanent vocal cord paralysis (0.6%). The postoperative stay for all groups was 1 day in 91 per cent of the cases. Patients from Groups 1 and 2 had no increased perioperative local complications or length of stay as compared with Group 3. Cervical neck dissection and thyroidectomy without drains is safe and effective in the treatment of WDTC.
本研究旨在回顾分化型甲状腺癌(WDTC)患者行甲状腺切除术联合颈部淋巴结清扫且不放置引流管的安全性。对连续接受WDTC甲状腺切除术且未放置引流管的患者的病历进行回顾性分析。第1组包括123例行甲状腺切除联合中央区淋巴结清扫的患者,第2组包括46例行甲状腺切除联合中央区及侧方淋巴结清扫的患者。127例行甲状腺切除未行淋巴结清扫的患者被纳入第3组。总体而言,16例患者(5%)出现术后血肿和/或血清肿,第1组7例(6%),第2组3例(7%),第3组6例(5%)。所有患者均有少量出血或血清肿,无需手术干预。总体而言,68例患者(23%)出现术后短暂性低钙血症,4例患者(1%)出现永久性甲状旁腺功能减退。17例患者(6%)出现术后短暂性声音嘶哑,3例出现永久性声带麻痹(0.6%)。所有组中91%的患者术后住院时间为1天。与第3组相比,第1组和第2组患者围手术期局部并发症未增加,住院时间也未延长。颈部淋巴结清扫联合甲状腺切除且不放置引流管在WDTC治疗中是安全有效的。