Emre Fatih Yunus, Doğan Ersoy, Keskinoğlu Pembe, Durak Merih Güray, Sarıoğlu Sülen, İkiz Ahmet Ömer
Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Department of Biostatistics and Medical Informatics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Turk Arch Otorhinolaryngol. 2023 Sep;61(3):118-123. doi: 10.4274/tao.2023.2023-5-19. Epub 2023 Nov 14.
The aim of the study was to retrospectively analyze the patients who underwent thyroidectomy at a tertiary academic center regarding their surgical indications, histopathological diagnosis, and surgical complications.
The study included a total of 739 consecutive patients who underwent lobectomy, total thyroidectomy, or completion thyroidectomy performed under intraoperative nerve monitoring (IONM) at the Department of Otorhinolaryngology-Head and Neck Surgery of Dokuz Eylül University between January 2009 and December 2019. Demographic data of the patients, preoperative clinicopathological characteristics, postoperative complications, characteristics of surgery and histopathological results were evaluated.
There were 619 patients in the primary surgery and 120 patients in the revision surgery groups. Indications for surgery were suspicion of malignancy in 486, multinodular goiter in 214, and hyperthyroidism in 39 patients. Final histopathological evaluation of specimens revealed malignancy in a total of 507 (68.6%) patients. Rates of transient and permanent hypocalcemia were 7.3% (54/739) and 2.2% (16/739) in the whole group, while this was 6.6% (41/619) and 1.5% (9/619), respectively, among primary total thyroidectomy patients. There were 61 (8.3%) patients with transient recurrent laryngeal nerve (RLN) paralysis (unilateral in 60 patients, bilateral in one patient) and five (0.7%) patients with permanent unilateral RLN paralysis as postoperative complications. Rates for postoperative hematoma, seroma, wound infection and chylous fistula were 2.2%, 3.7%, 0.1%, and 0.5%, respectively.
Our results support the safety of thyroid surgery performed under IONM in tertiary academic centers. Every institution should document and share its own results to properly inform its patients preoperatively.
本研究旨在回顾性分析在一家三级学术中心接受甲状腺切除术的患者的手术指征、组织病理学诊断及手术并发症。
本研究纳入了2009年1月至2019年12月期间在多库兹艾于勒大学耳鼻咽喉头颈外科接受叶切除术、全甲状腺切除术或在术中神经监测(IONM)下进行的再次甲状腺切除术的739例连续患者。评估了患者的人口统计学数据、术前临床病理特征、术后并发症、手术特征及组织病理学结果。
初次手术组有619例患者,再次手术组有120例患者。手术指征为怀疑恶性肿瘤486例、多结节性甲状腺肿214例、甲状腺功能亢进39例。标本的最终组织病理学评估显示,共有507例(68.6%)患者为恶性肿瘤。全组患者中,短暂性和永久性低钙血症的发生率分别为7.3%(54/739)和2.2%(16/739),而在初次全甲状腺切除术患者中,这一比例分别为6.6%(41/619)和1.5%(9/619)。术后有61例(8.3%)患者发生短暂性喉返神经(RLN)麻痹(60例为单侧,1例为双侧),5例(0.7%)患者发生永久性单侧RLN麻痹。术后血肿、血清肿、伤口感染和乳糜瘘的发生率分别为2.2%、3.7%、0.1%和0.5%。
我们的结果支持在三级学术中心在IONM下进行甲状腺手术的安全性。每个机构都应记录并分享自己的结果,以便在术前适当地告知患者。