Makay Özer
Division of Endocrine Surgery, Department of General Surgery, Ege University Hospital, Izmir, Turkey.
Gland Surg. 2017 Dec;6(Suppl 1):S49-S58. doi: 10.21037/gs.2017.10.02.
Benign goiter is the most common endocrine disease that requires surgery, especially in endemic areas suffering from iodine-deficiency. Recent European and American guidelines recommended total thyroidectomy for the surgical treatment of multinodular goiter. Total thyroidectomy has now become the technique of choice and is widely considered the most reliable approach in preventing recurrence. Nevertheless, total thyroidectomy carries a substantial risk in terms of hypoparathyroidism and the morbidity associated with injury to the inferior laryngeal nerve. In this context, partial/less-than-total thyroidectomy is being considered once again as a viable alternative. This review will discuss the extent of thyroid surgery for benign disease and the impact of the surgical protocol on the patient- and surgeon-specific risk factors for specific complication rates.
良性甲状腺肿是最常见的需要手术治疗的内分泌疾病,在碘缺乏的流行地区尤为如此。最近的欧美指南推荐对多结节性甲状腺肿进行手术治疗时采用全甲状腺切除术。全甲状腺切除术现已成为首选技术,并且被广泛认为是预防复发的最可靠方法。然而,全甲状腺切除术在甲状旁腺功能减退以及与喉返神经损伤相关的发病率方面存在重大风险。在这种情况下,部分/次全甲状腺切除术再次被视为一种可行的替代方案。本综述将讨论良性疾病甲状腺手术的范围以及手术方案对特定并发症发生率的患者和外科医生特定风险因素的影响。