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[甲状腺次全切除术或全甲状腺切除术治疗良性甲状腺疾病。我们的经验]

[Subtotal thyroidectomy or total thyroidectomy in the treatment of benign thyroid disease. Our experience].

作者信息

Siragusa G, Lanzara P, Di Pace G

机构信息

Dipartimento di Discipline Chirurgiche ed Anatomiche, Università degli Studi, Palermo.

出版信息

Minerva Chir. 1998 Apr;53(4):233-8.

PMID:9701976
Abstract

During the period January 1989-December 1994, of 322 thyroid operations, 309 were benign. The pathologic changes in the excised thyroids were 18 benign adenoma, 291 goiter 9 of which with thyroiditis. 25 patients had undergone previous partial thyroidectomy. Total thyroidectomy was performed in 224 patients. There were no operative deaths. 77 (34.3%) patients developed postoperative hypocalcemia, 10 (2.7%) transient hypoparathyroidism, 4 (1.8%) permanent hypoparathyroidism, 3 (1.3%) transient recurrent laryngeal nerve palsies, 2 (0.9%) permanent nerve damages. In our experience total thyroidectomy is the gold standard for diffuse diseases of the thyroid, because, without more specific complication than subtotal thyroidectomy, it ensures: no recurrences, an easy control of postoperative hypothyroidism, the removal of microscopic malignant foci, the stopping of ophthalmopathy evolution.

摘要

在1989年1月至1994年12月期间,322例甲状腺手术中,309例为良性。切除甲状腺的病理变化为18例良性腺瘤、291例甲状腺肿,其中9例伴有甲状腺炎。25例患者曾接受过甲状腺部分切除术。224例患者接受了甲状腺全切除术。无手术死亡病例。77例(34.3%)患者术后发生低钙血症,10例(2.7%)发生短暂性甲状旁腺功能减退,4例(1.8%)发生永久性甲状旁腺功能减退,3例(1.3%)发生短暂性喉返神经麻痹,2例(0.9%)发生永久性神经损伤。根据我们的经验,甲状腺全切除术是甲状腺弥漫性疾病的金标准,因为它与甲状腺次全切除术相比没有更特殊的并发症,且能确保:无复发、易于控制术后甲状腺功能减退、切除微小恶性病灶、阻止眼病进展。

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