al-Suliman N N, Graversen H P, Blichert-Toft M
Odense Sygehus, kirurgisk afdeling K.
Ugeskr Laeger. 1994 Jan 10;156(2):165-9.
Centre experience of reoperation for recurrent goitre in 82 patients during an 11-year period is analysed. The lateralposterior approach is used as a standard surgical technique. Postoperative complications are prevalent only among patients previously operated on the thyroid gland twice or more, among patients with recurrent intrathoracic goitre, and among patients with large goitre relapse. Frequency of permanent unilateral vocal cord paresis amounts to 3.6%. There were no cases of bilateral recurrent nerve damage. The incidence of hypocalcemia requiring permanent treatment reaches 1.2%. Centre experience tends to reduce surgical complications rates with increasing specialized training. The surgical treatment for recurrent goitre ought to be radical to avoid further relapses. We recommend lobectomy in cases of unilateral recurrence and lobectomy of the dominant lobe with contralateral resection in case of bilateral relapse.
分析了11年间82例复发性甲状腺肿再次手术的中心经验。采用侧后入路作为标准手术技术。术后并发症仅在之前接受过两次或更多次甲状腺手术的患者、复发性胸内甲状腺肿患者以及巨大甲状腺肿复发患者中普遍存在。永久性单侧声带麻痹的发生率为3.6%。没有双侧喉返神经损伤的病例。需要长期治疗的低钙血症发生率达到1.2%。随着专业培训的增加，中心经验倾向于降低手术并发症发生率。复发性甲状腺肿的手术治疗应该彻底，以避免进一步复发。对于单侧复发，我们建议行甲状腺叶切除术；对于双侧复发，建议行优势侧甲状腺叶切除术并对侧切除。
