Pomata M, Ragazzo G, Pisano G, Farina G P
Istituto di Chirurgia, Università degli Studi di Cagliari.
G Chir. 1990 Jun;11(6):351-5.
The Authors report the results of a series of 502 thyroid operations (bilateral in 322 cases [64%] and unilateral in 180 cases [36%]), with the aim to evaluate the incidence of early complications and to establish when they were more likely to occur. Preoperative diagnosis was based on scintigraphic scan recently combined to ultrasonography with fine needle biopsy. In all patients a pre and postoperative control of vocal cords motility was performed. Intraoperative identification of recurrent laryngeal nerve was the rule. Complications include a single case of mortality due to cerebral haemorrhage, 2 cases of monolateral recurrent laryngeal nerve paralysis, 4 cases of transient dysphonia, 8 cases of temporary hypoparathyroidism, 5 cases of postoperative bleeding. In three patients a temporary tracheostomy was needed. Thyrotoxic storm did not occur and wound infections were negligible. The various thyroid diseases and their different biological behavior are responsible of the risk factors, local and general ones, which the surgeon must recognize. Diagnostic accuracy, meticulous surgical technique and the best treatment at the first approach are the main factors to prevent complications in thyroid surgery.
作者报告了一系列502例甲状腺手术的结果（双侧手术322例[64%]，单侧手术180例[36%]），目的是评估早期并发症的发生率，并确定其更易发生的时间。术前诊断基于近期结合超声和细针穿刺活检的闪烁扫描。所有患者均进行了术前和术后声带运动的检查。术中常规识别喉返神经。并发症包括1例因脑出血死亡、2例单侧喉返神经麻痹、4例短暂性发音困难、8例暂时性甲状旁腺功能减退、5例术后出血。3例患者需要临时气管切开术。未发生甲状腺危象，伤口感染可忽略不计。各种甲状腺疾病及其不同的生物学行为是导致危险因素的原因，包括局部和全身因素，外科医生必须认识到这些因素。诊断准确性、细致的手术技巧以及首次手术时的最佳治疗是预防甲状腺手术并发症的主要因素。
