Hu Jisheng, Zhao Nan, Kong Rui, Wang Dawei, Sun Bei, Wu Lifeng
Department of Pancreatic and Biliary Surgery, First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang Province, China.
Department of Respiratory Medicine, First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang Province, China.
World J Surg Oncol. 2016 Jan 22;14(1):20. doi: 10.1186/s12957-016-0772-1.
The objective of this study was to evaluate the safety of total thyroidectomy for thyroid disorders and summarise the treatment experience in a less-developed region.
This was a retrospective observational cohort study using the computerised database of the First Affiliated Hospital of Harbin Medical University. All consecutive thyroidectomy patients from 2003 to 2014 were included in this study. Demographics, surgical procedure, diagnoses, morbidity and mortality were retrospectively reviewed.
There were a total of 714 men and 4845 women in this study, with a mean age of 55 (range 9-87) years. A total of 4632 patients underwent total thyroidectomy for primary surgical treatment, and 189 patients previously underwent partial thyroidectomy. A total of 56.2% of the patients had multinodular goitre, including 12.23% who were thyrotoxic. Graves' disease and Hashimoto's disease were diagnosed in 2.82 and 7.23% of the patients, respectively. Papillary thyroid cancer was identified in 1336 patients, 44.99% of whom had papillary microcarcinoma. The total prevalence of permanent complications of first-time and secondary surgeries was 0.35 and 7.41%, respectively. During thyroid surgery, 945 patients underwent parathyroid autotransplantation.
Initial total thyroidectomy can be safely performed for both benign and malignant thyroid diseases in a less-developed region. The morbidity of a secondary surgical procedure after subtotal thyroidectomy is significantly high compared to first-time surgery.
本研究的目的是评估甲状腺疾病全甲状腺切除术的安全性，并总结在欠发达地区的治疗经验。
这是一项回顾性观察队列研究，使用哈尔滨医科大学附属第一医院的计算机数据库。纳入了2003年至2014年所有连续接受甲状腺切除术的患者。对人口统计学、手术过程、诊断、发病率和死亡率进行回顾性分析。
本研究共有714名男性和4845名女性，平均年龄为55岁（范围9 - 87岁）。共有4632例患者接受全甲状腺切除术作为初次手术治疗，189例患者此前接受过部分甲状腺切除术。共有56.2%的患者患有结节性甲状腺肿，其中12.23%为甲状腺毒症。分别有2.82%和7.23%的患者被诊断为格雷夫斯病和桥本氏病。1336例患者被确诊为甲状腺乳头状癌，其中44.99%为甲状腺微小癌。初次手术和二次手术永久性并发症的总发生率分别为0.35%和7.41%。在甲状腺手术期间，945例患者接受了甲状旁腺自体移植。
在欠发达地区，对于良性和恶性甲状腺疾病均可安全地进行初次全甲状腺切除术。与初次手术相比，甲状腺次全切除术后二次手术的发病率明显较高。
