Chao T C, Jeng L B, Lin J D, Chen M F
Department of Surgery, Chang Gung Medical College and Chang Gung Memorial Hospital, Taipei, Taiwan.
Otolaryngol Head Neck Surg. 1998 Jun;118(6):896-9. doi: 10.1016/S0194-5998(98)70294-3.
Completion thyroidectomy is performed because of a deferred diagnosis of differentiated carcinoma of the thyroid or a significant thyroid remnant after initial operation. During a period of 6 years, data from 40 patients with differentiated thyroid carcinoma undergoing completion thyroidectomy were retrospectively reviewed. There were 4 men and 36 women (1:9), and the average age was 39.6+/-1.9 years (range, 20 to 62 years). The indications for the initial surgery were a solitary thyroid nodule in 36 (90%) patients, multinodular goiter in 3 (7.5%) patients, and Graves' disease in 1 (2.5%) patient. Three patients underwent completion thyroidectomy during the same hospital stay. In the remaining 37 patients, completion thyroidectomy was performed 4 to 252 days (44.1+/-7.8 days) after the initial operation. The length of hospital stay for the initial operation was not different from that for completion thyroidectomy (5.1+/-0.3 days vs. 5.2+/-0.3 days). The length of time needed to accomplish the initial operation was not different from that required for the completion thyroidectomy (122+/-7.5 minutes vs. 110.8+/-5.9 minutes). There was no 30-day perioperative mortality. The postoperative morbidity in completion thyroidectomy consisted of transient hypoparathyroidism in 3 (7.5%) patients, permanent hypoparathyroidism in 1 (2.5%) patient, transient recurrent laryngeal nerve palsy in 1 (2.5%) patient, and permanent recurrent laryngeal nerve palsy in 1 (2.5%) patient. On the other hand, one transient recurrent laryngeal nerve palsy and one transient hypoparathyroidism occurred at the initial operation. Completion thyroidectomy is a safe procedure to remove the thyroid remnant.
因甲状腺分化癌诊断延迟或初次手术后残留大量甲状腺组织而进行甲状腺全切术。在6年期间，对40例行甲状腺全切术的分化型甲状腺癌患者的数据进行回顾性分析。其中男性4例，女性36例（1:9），平均年龄39.6±1.9岁（范围20至62岁）。初次手术的指征为：36例（90%）患者为单发甲状腺结节，3例（7.5%）患者为结节性甲状腺肿，1例（2.5%）患者为格雷夫斯病。3例患者在同一次住院期间行甲状腺全切术。其余37例患者在初次手术后4至252天（44.1±7.8天）行甲状腺全切术。初次手术的住院时间与甲状腺全切术的住院时间无差异（5.1±0.3天对5.2±0.3天）。完成初次手术所需时间与甲状腺全切术所需时间无差异（122±7.5分钟对110.8±5.9分钟）。围手术期30天内无死亡病例。甲状腺全切术后的并发症包括3例（7.5%）患者出现暂时性甲状旁腺功能减退，1例（2.5%）患者出现永久性甲状旁腺功能减退，1例（2.5%）患者出现暂时性喉返神经麻痹，1例（2.5%）患者出现永久性喉返神经麻痹。另一方面，初次手术时出现1例暂时性喉返神经麻痹和1例暂时性甲状旁腺功能减退。甲状腺全切术是一种安全的切除残留甲状腺组织的手术。
