Frank Ethan D, Park Joshua S, Watson WayAnne, Chong Esther, Yang Sara, Simental Alfred A
Department of Otolaryngology, Loma Linda University Medical Center, Loma Linda, California, USA.
Loma Linda University School of Medicine, Loma Linda, California, USA.
Head Neck. 2020 Aug;42(8):2123-2128. doi: 10.1002/hed.26148. Epub 2020 Mar 21.
While use of total thyroidectomy has increased in management of hyperthyroidism, concerns exist about increased surgical complication rates; most notably, hematoma, recurrent laryngeal nerve (RLN) injury, and hypocalcemia.
Retrospective cohort study of 454 patients undergoing total thyroidectomy between 2003 and 2015. All patients had surgery for hyperthyroidism, benign euthyroid disease, or thyroid malignancy.
Total thyroidectomy for hyperthyroidism was not associated with an increased risk for any postoperative complication. Transient hypocalcemia, temporary dysphonia, and postoperative hematoma rates were not significantly different for patients with hyperthyroid (n = 91), euthyroid benign (n = 237), and malignant (n = 126) disease. Permanent hypocalcemia and recurrent laryngeal nerve injury were not noted in any hyperthyroid patients. Complication rates were similar for hyperthyroid patients with Graves' disease vs toxic multinodular goiter.
This study affirms safety and efficacy of total thyroidectomy as standard treatment for hyperthyroidism.
虽然甲状腺全切除术在甲亢治疗中的应用有所增加，但人们担心手术并发症发生率会上升；最值得注意的是血肿、喉返神经（RLN）损伤和低钙血症。
对2003年至2015年间接受甲状腺全切除术的454例患者进行回顾性队列研究。所有患者均因甲亢、良性甲状腺功能正常疾病或甲状腺恶性肿瘤接受手术。
甲亢患者行甲状腺全切除术与任何术后并发症风险增加均无关联。甲亢患者（n = 91）、甲状腺功能正常的良性疾病患者（n = 237）和恶性疾病患者（n = 126）的短暂性低钙血症、暂时性声音嘶哑和术后血肿发生率无显著差异。任何甲亢患者均未出现永久性低钙血症和喉返神经损伤。Graves病甲亢患者与毒性多结节性甲状腺肿患者的并发症发生率相似。
本研究证实了甲状腺全切除术作为甲亢标准治疗方法的安全性和有效性。
