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根据在尼亚美参考总医院的普通外科医生、耳鼻喉科医生和颈面外科医生的甲状腺切除术结果,管理方案有何不同?

Results of thyroidectomies according to general surgeons and otolaryngologist and cervico faciale surgeons at the general Hospital of Reference of Niamey, what differences in the protocols of management?

机构信息

Department of General and Digestive Surgery, Reference General Hospital, 12 674, Niamey, BP, Niger.

Department of Otolaryngology and Cervico Facial Surgery, Reference General Hospital, 12 674, Niamey, BP, Niger.

出版信息

BMC Surg. 2024 Jan 18;24(1):28. doi: 10.1186/s12893-023-02305-y.

Abstract

OBJECTIVE

To evaluate the surgical management of thyroid pathologies at the Reference General Hospital.

METHODS

This was a retro-prospective study over 4 years 6 months carried out in the departments of General and Digestive Surgery (GDS) and Otorhinolaryngology and Cervico Facial Surgery (ORL/FCS). It involved 182 patients who underwent thyroid surgery.

RESULTS

A frequency of thyroidectomy of 9.46% was found. Females predominated with a sex ratio of 0.1. The average age of patients was 42.85 years, a standard deviation 12.80. 84.06% of patients had consulted for anterior cervical mass. EU-TIRADS score 3 represented 7,14% of cases. Heteromultinodular goiter was the main indication for thyroid surgery (59.34%). Total thyroidectomy was the most commonly performed gesture in general surgery in 88,23% (n = 105), in Otorhinolaryngology, it was in the same proportion as lobo-isthmectomy at 47.61% (n = 30). The first route was video-assisted thyroidectomy 2.2% (n = 4). The recurrent laryngeal nerve was dissected and seen in 159 cases (87.36%) and parathyroid glands were also seen and preserved in 58.24% of cases (n = 106). In immediate postoperative surgery, the main complications were unilateral recurrent paralysis with dysphonia in 3.3% (n = 6) and compressive hematoma in 2.2% (n = 4). No deaths had been recorded.

CONCLUSION

Total thyroidectomy was the most performed procedure in department of General and Digestive Surgery. Routine oral calcium and vitamin D supplementation in the general surgery ward, reduces the occurrence of hypocalcemia after total thyroidectomy and allows a safe and early exit. Standardizing protocols will further reduce complications.

摘要

目的

评估参考总医院的甲状腺疾病的手术治疗方法。

方法

这是一项在普外科(GDS)和耳鼻喉头颈外科(ORL/FCS)进行的为期 4 年 6 个月的回顾性前瞻性研究,共纳入 182 例接受甲状腺手术的患者。

结果

甲状腺切除术的频率为 9.46%。女性占主导地位,男女比例为 0.1。患者的平均年龄为 42.85 岁,标准差为 12.80。84.06%的患者因颈前肿块就诊。EU-TIRADS 评分 3 代表 7.14%的病例。多结节性甲状腺肿是甲状腺手术的主要适应证(59.34%)。普外科最常见的手术方式为甲状腺全切除术,占 88.23%(n=105),耳鼻喉科则为甲状腺叶加峡部切除术,占 47.61%(n=30)。第一种途径是视频辅助甲状腺切除术,占 2.2%(n=4)。159 例(87.36%)患者的喉返神经被解剖并可见,58.24%(n=106)的患者甲状旁腺也被可见并保留。术后即刻手术的主要并发症为单侧喉返神经麻痹伴声嘶 3.3%(n=6)和压迫性血肿 2.2%(n=4)。无死亡病例。

结论

甲状腺全切除术是普外科最常进行的手术。普外科常规口服钙剂和维生素 D 补充,可减少甲状腺全切除术后低钙血症的发生,使患者安全、及早出院。标准化方案将进一步减少并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9df3/10795351/324c56517242/12893_2023_2305_Fig1_HTML.jpg

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