Wahl R, Nievergelt J, Röher H D, Oellers B
Dtsch Med Wochenschr. 1977 Jan 7;102(1):13-6, 19-20. doi: 10.1055/s-0028-1104834.
270 patients were operated on for malignant thyroid tumour between 1955 and 1974. Before 1967, less radical methods of operation had been preferred, but since 1968, radical thyroidectomy - if necessary supplemented by selective or radical neck dissection - has become the procedure of choice if a curative operation was still feasible. This has brought about a significant fall in the incidence of recurrences and increased the survival rate in patients with well-differentiated carcinoma. The proportion of postoperative complications has been within reasonable bounds. The incidence of postoperative recurrent-nerve paralysis, at 9.4%, has not been raised by radical procedures, while the proportion of permanent tetany (11%) after radical thyroidectomy is much higher than after sub-total resection (2%). But the advantages of radical thyroidectomy outweigh the increased incidence of postoperative hypoparathyroidism.
1955年至1974年间,270例患者接受了甲状腺恶性肿瘤手术。1967年以前,人们更倾向于采用不太彻底的手术方法,但自1968年以来,如果根治性手术仍可行,根治性甲状腺切除术(必要时辅以选择性或根治性颈部清扫术)已成为首选术式。这使得复发率显著下降,并提高了高分化癌患者的生存率。术后并发症的比例在合理范围内。根治性手术并未使术后喉返神经麻痹的发生率升高,为9.4%,而根治性甲状腺切除术后永久性手足搐搦的比例(11%)远高于次全切除术后(2%)。但根治性甲状腺切除术的优点超过了术后甲状旁腺功能减退发生率的增加。