Pappalardo G, Guadalaxara A, Frattaroli F M, Illomei G, Falaschi P
2nd Surgical Clinic--Policlinico Umberto I, University of Rome, La Sapienza, Italy.
Eur J Surg. 1998 Jul;164(7):501-6. doi: 10.1080/110241598750005840.
To evaluate the outcome after total and subtotal thyroidectomy for the treatment of single and multinodular goitres in two comparable groups of patients.
Prospective randomised study.
University hospital, Italy.
141 Patients operated on for benign goitre from 1975-85.
69 Patients were randomised to have total thyroidectomy and 72 subtotal thyroidectomy by standard techniques.
Temporary or permanent palsy of the recurrent laryngeal nerve, temporary or permanent hypoparathyroidism, recurrence of the goitre, and the incidence of iatrogenic injuries after completion thyroidectomy.
Patients were followed up for a median of 14.5 years (range 10-21). After total thyroidectomy 2 patients (3%) developed temporary palsy of the recurrent laryngeal nerve but there were no permanent lesions; and 24 (35%) developed temporary and 2 (3%) permanent hypoparathyroidism. After subtotal thyroidectomy 2 (3%) developed temporary and 1 (1%) permanent palsy of the recurrent laryngeal nerve; and 13 (18%) developed temporary and 1 (1%) permanent hypoparathyroidism. In addition, there were 10 recurrent goitres (14%). After completion thyroidectomy (n = 9) there were 2 cases of temporary and 1 of permanent palsy of the recurrent laryngeal nerve, and 2 cases of temporary and 2 of permanent hypoparathyroidism.
Total thyroidectomy is the procedure of choice for the treatment of benign nodular goitre.
评估在两组具有可比性的患者中，全甲状腺切除术和次全甲状腺切除术治疗单发和多发结节性甲状腺肿后的结果。
前瞻性随机研究。
意大利大学医院。
1975年至1985年期间因良性甲状腺肿接受手术的141例患者。
69例患者通过标准技术随机接受全甲状腺切除术，72例接受次全甲状腺切除术。
喉返神经的暂时性或永久性麻痹、暂时性或永久性甲状旁腺功能减退、甲状腺肿复发以及甲状腺切除术后医源性损伤的发生率。
患者的中位随访时间为14.5年（范围10 - 21年）。全甲状腺切除术后，2例患者（3%）出现喉返神经暂时性麻痹，但无永久性损伤；24例（35%）出现暂时性甲状旁腺功能减退，2例（3%）出现永久性甲状旁腺功能减退。次全甲状腺切除术后，2例（3%）出现喉返神经暂时性麻痹，1例（1%）出现永久性麻痹；13例（18%）出现暂时性甲状旁腺功能减退，1例（1%）出现永久性甲状旁腺功能减退。此外，有10例甲状腺肿复发（14%）。甲状腺切除术后（n = 9），有2例出现喉返神经暂时性麻痹，1例出现永久性麻痹，2例出现暂时性甲状旁腺功能减退，2例出现永久性甲状旁腺功能减退。
全甲状腺切除术是治疗良性结节性甲状腺肿的首选术式。
