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全甲状腺切除术后与甲状腺次全切除术后功能结局的比较:甲状旁腺功能减退症及术后并发症

Comparison of functional outcomes after total thyroidectomy and completion thyroidectomy: Hypoparathyroidism and postoperative complications.

作者信息

Park Young Min, Kim Jeong-Rok, Oh Kyung Ho, Cho Jae-Gu, Baek Seung-Kuk, Kwon Soon-Young, Jung Kwang-Yoon, Woo Jeong-Soo

机构信息

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea.

出版信息

Auris Nasus Larynx. 2019 Feb;46(1):101-105. doi: 10.1016/j.anl.2018.03.009. Epub 2018 Apr 8.

Abstract

OBJECTIVE

This study aimed to investigate differences in functional outcomes of postoperative complications and hypoparathyroidism between patients who underwent completion thyroidectomy (CT) after thyroid lobectomy or total thyroidectomy (TT) as an initial treatment.

MATERIALS AND METHODS

We retrospectively analyzed the differences of functional outcomes after completion thyroidectomy and total thyroidectomy without lymph node dissection. We reviewed the medical records of 396 patients who underwent CT or TT for thyroid disease at Korea University Guro Hospital from March 2002 to August 2016.

RESULTS

Of the 396 patients, 32 underwent CT and 364 underwent TT. There were 72 male patients and 324 female patients. Transient hypoparathyroidism was observed in 4 (9.4%) of the CT patients and 97 (26.6%) of the TT patients, with a statistically significant difference (p=0.031). Permanent hypoparathyroidism was observed in 1 patient (3.1%) in the CT group and in 13 patients (3.6%) in the TT group, which was not significantly different. There were no significant differences in the postoperative complication of temporary recurrent laryngeal nerve injury, wound infection, and hematoma between two patients group.

CONCLUSION

The incidence of transient hypoparathyroidism in CT patients was significantly lower than in TT patients. These safety and functional superiority of CT should be considered when determining the scope and extent of operation in patients requiring surgery for thyroid disease.

摘要

目的

本研究旨在调查甲状腺叶切除术或全甲状腺切除术(TT)作为初始治疗后接受甲状腺全切术(CT)的患者术后并发症和甲状旁腺功能减退的功能结局差异。

材料与方法

我们回顾性分析了甲状腺全切术和未进行淋巴结清扫的全甲状腺切除术后功能结局的差异。我们查阅了2002年3月至2016年8月在韩国大学古罗医院接受CT或TT治疗甲状腺疾病的396例患者的病历。

结果

396例患者中,32例行CT,364例行TT。男性患者72例,女性患者324例。CT组4例(9.4%)出现短暂性甲状旁腺功能减退,TT组97例(26.6%)出现短暂性甲状旁腺功能减退,差异有统计学意义(p=0.031)。CT组1例(3.1%)出现永久性甲状旁腺功能减退,TT组13例(3.6%)出现永久性甲状旁腺功能减退,差异无统计学意义。两组患者在暂时性喉返神经损伤、伤口感染和血肿的术后并发症方面无显著差异。

结论

CT患者短暂性甲状旁腺功能减退的发生率显著低于TT患者。在确定需要手术治疗甲状腺疾病的患者的手术范围和程度时,应考虑CT的这些安全性和功能优势。

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