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Risk factors for recurrence and morbidity in reoperative thyroid surgery: a different point of view

Year 2013, , 417 - 421, 01.12.2013
https://doi.org/10.5799/ahinjs.01.2013.04.0317

Abstract

Objective: Recurrent goiter is a common problem following subtotal thyroid gland resection for multinodular goiter disease. The aim of the present study is to evaluate risk factors for recurrence, ultrastructural particularities of the thyroid and morbidity rate in relation to the side of initial and redo surgery for recurrent disease. Methods: From January 2003 to December 2010 a total of 4,395 patients underwent consecutive thyroid gland surgery for nodular goiter at Department of Endocrine Surgery USBALE “Akad. Iv. Penchev” Hospital. Five hundred fifty one (12.5%) patients underwent redo-surgery for recurrent disease after subtotal resection. All of them with complete follow-up were included in the present study. Results: Recurrent disease was found in 279 (50.7%) patients in the ipsilateral lobe and 272 (49.3%) patients in the contralateral lobe. The incidence of permanent recurrent laryngeal nerve palsy was significantly higher in patients with ipsilateral redo surgery compared to patients undergoing initial operation (3.9% vs. 1.2%; p

References

  • Tezelman S, Borucu I, Senyurek Y, Tunca F. The change in surgical practice from subtotal to near-total. World J Surg 2009;33:400-440.
  • Barczyński M, Konturek A, Stopa M, et al. Total thyroid- ectomy for benign thyroid disease: is it really worth- while? Ann Surg 2011;254:724-730.
  • Menegaux F, Turpin G, Dahman M, et al. Secondary thyroidectomy in patients with prior thyroid surgery for benign disease: a study of 203 cases. Surgery 1999;126:479-483.
  • Kraimps JL, Marechaud R, Gineste D, et al. Analysis and prevention of recurrent goiter. Surg Gynecol Ob- stet 1993;176:319-322.
  • Pappalardo G, Guadalaxara A, Frattaroli FM, et al. To- tal compared with subtotal thyroidectomy in benign nodular disease:personal series and review of pub- lished reports. Eur J Surg 1998;164:501-506.
  • Wadstrom C, Zedenius J, Guinea A, et al. Multinodu- lar goitre presenting as a clinical single nodule: how effective is hemithyroidectomy? Aust N Z J Surg 1999;69:34-36.
  • Muller PE, Jakoby R, Heinert G, Spelsberg F. Surgery for recurrent goitre: its complications and their risk factors. Eur J Surg 2001;167:816-821.
  • Moalem J, Suh I, Duh QY. Treatment and prevention of recurrence of multinodular goiter: an evidence-based review of the literature. World J Surg 2008;32:1301- 1312.
  • Peix JL, Van Box Som P, Olagne E, et al. Results of reoperations for goiter. Ann Chir 1997;51:217-221.
  • Berghout A, Wiersinga WM, Drexhage HA, et al. The long-term outcome of thyroidectomy for sporadic non- toxic goitre. Clin Endocrinol (Oxf) 1989;31:193-199.
  • Harrer P, Bröcker M, Zint A, et al. The clonality of nod- ules in recurrent goiters at second surgery. Langen- becks Arch Surg 1998;383:453-455.
  • Studer H, Gerber H, Zbaeren J, Peter HJ. Histomor- phological and immunohistochemical evidence that human nodular goiters grow by episodic replication of multiple clusters of thyroid follicular cells. J Clin Endo- crinol Metab 1992;75:1151-1158.
  • Böttcher Y, Eszlinger M, Tönjes A, Paschke R. The genetics of euthyroid familial goiter. Trends Endocri- nol Metab 2005;16:314-319.
  • Brix TH, Hegedüs L. Genetic and environmental factors in the aetiology of simple goitre. Ann Med 2000;32:153-156.
  • Bauer PS, Murray S, Clark N, et al. Unilateral thyroid- ectomy for the treatment of benign multinodular goiter. J Surg Res 2013;184:514-518.

Reoperatif tiroid cerrahisinde nüks ve morbidite oranı için risk faktörleri: farklı bir bakış açısı

Year 2013, , 417 - 421, 01.12.2013
https://doi.org/10.5799/ahinjs.01.2013.04.0317

Abstract

Amaç: Tekrarlayan (nüks) guatr, multinodüler guatr hastalığı tedavisi için yapılan subtotal tiroid bezi rezeksiyonunu takiben gelişen yaygın bir sorundur. Bu çalışmanın amacı; tekrarlayan guatr hastalığının başlangıcı ve redo cerrahi ile ilgili olarak nüks, tiroidin ultrastrüktürel özellikleri ve morbidite oranı yönünden risk faktörlerini değerlendirmektir. Yöntemler: Ocak 2003-Aralık 2010 tarihleri arasında USBALE “Akad. Iv. Penchev” Hastanesi Endokrin Cerrahi bölümünde toplam 4,395 hastaya nodüler guatr tedavisi için ardışık tiroid bezi cerrahisi uygulandı. Hastalardan 551\'ine (%12,5) subtotal rezeksiyon sonrası gelişen tekrarlayan hastalık tedavisi için redo cerrahi yapıldı. Takip edilen hastaların tamamı çalışmaya dahil edildi. Bulgular: Tekrarlayan (nüks) guatr hastaların 279\'unda (%50,7) ipsilateral lob ve 272\'sinde (%49,3) kotralateral lob yerleşimliydi. Kalıcı tekrarlayan laringeal sinir felci açısından, hastalara yapılan ilk operasyon ile karşılaştırıldığında; kontralateral redo cerrahi geçiren hastalarla arasında herhangi bir fark bulunmazken ipsilateral redo cerrahi geçiren hastalarda anlamlı olarak daha yüksekti (3,9% vs. 1,2%; p

References

  • Tezelman S, Borucu I, Senyurek Y, Tunca F. The change in surgical practice from subtotal to near-total. World J Surg 2009;33:400-440.
  • Barczyński M, Konturek A, Stopa M, et al. Total thyroid- ectomy for benign thyroid disease: is it really worth- while? Ann Surg 2011;254:724-730.
  • Menegaux F, Turpin G, Dahman M, et al. Secondary thyroidectomy in patients with prior thyroid surgery for benign disease: a study of 203 cases. Surgery 1999;126:479-483.
  • Kraimps JL, Marechaud R, Gineste D, et al. Analysis and prevention of recurrent goiter. Surg Gynecol Ob- stet 1993;176:319-322.
  • Pappalardo G, Guadalaxara A, Frattaroli FM, et al. To- tal compared with subtotal thyroidectomy in benign nodular disease:personal series and review of pub- lished reports. Eur J Surg 1998;164:501-506.
  • Wadstrom C, Zedenius J, Guinea A, et al. Multinodu- lar goitre presenting as a clinical single nodule: how effective is hemithyroidectomy? Aust N Z J Surg 1999;69:34-36.
  • Muller PE, Jakoby R, Heinert G, Spelsberg F. Surgery for recurrent goitre: its complications and their risk factors. Eur J Surg 2001;167:816-821.
  • Moalem J, Suh I, Duh QY. Treatment and prevention of recurrence of multinodular goiter: an evidence-based review of the literature. World J Surg 2008;32:1301- 1312.
  • Peix JL, Van Box Som P, Olagne E, et al. Results of reoperations for goiter. Ann Chir 1997;51:217-221.
  • Berghout A, Wiersinga WM, Drexhage HA, et al. The long-term outcome of thyroidectomy for sporadic non- toxic goitre. Clin Endocrinol (Oxf) 1989;31:193-199.
  • Harrer P, Bröcker M, Zint A, et al. The clonality of nod- ules in recurrent goiters at second surgery. Langen- becks Arch Surg 1998;383:453-455.
  • Studer H, Gerber H, Zbaeren J, Peter HJ. Histomor- phological and immunohistochemical evidence that human nodular goiters grow by episodic replication of multiple clusters of thyroid follicular cells. J Clin Endo- crinol Metab 1992;75:1151-1158.
  • Böttcher Y, Eszlinger M, Tönjes A, Paschke R. The genetics of euthyroid familial goiter. Trends Endocri- nol Metab 2005;16:314-319.
  • Brix TH, Hegedüs L. Genetic and environmental factors in the aetiology of simple goitre. Ann Med 2000;32:153-156.
  • Bauer PS, Murray S, Clark N, et al. Unilateral thyroid- ectomy for the treatment of benign multinodular goiter. J Surg Res 2013;184:514-518.
There are 15 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Kalin Nicolaev Vidinov This is me

Georgi Petrov Georgiev This is me

Publication Date December 1, 2013
Published in Issue Year 2013

Cite

APA Vidinov, K. N., & Georgiev, G. P. (2013). Reoperatif tiroid cerrahisinde nüks ve morbidite oranı için risk faktörleri: farklı bir bakış açısı. Journal of Clinical and Experimental Investigations, 4(4), 417-421. https://doi.org/10.5799/ahinjs.01.2013.04.0317
AMA Vidinov KN, Georgiev GP. Reoperatif tiroid cerrahisinde nüks ve morbidite oranı için risk faktörleri: farklı bir bakış açısı. J Clin Exp Invest. December 2013;4(4):417-421. doi:10.5799/ahinjs.01.2013.04.0317
Chicago Vidinov, Kalin Nicolaev, and Georgi Petrov Georgiev. “Reoperatif Tiroid Cerrahisinde nüks Ve Morbidite Oranı için Risk faktörleri: Farklı Bir bakış açısı”. Journal of Clinical and Experimental Investigations 4, no. 4 (December 2013): 417-21. https://doi.org/10.5799/ahinjs.01.2013.04.0317.
EndNote Vidinov KN, Georgiev GP (December 1, 2013) Reoperatif tiroid cerrahisinde nüks ve morbidite oranı için risk faktörleri: farklı bir bakış açısı. Journal of Clinical and Experimental Investigations 4 4 417–421.
IEEE K. N. Vidinov and G. P. Georgiev, “Reoperatif tiroid cerrahisinde nüks ve morbidite oranı için risk faktörleri: farklı bir bakış açısı”, J Clin Exp Invest, vol. 4, no. 4, pp. 417–421, 2013, doi: 10.5799/ahinjs.01.2013.04.0317.
ISNAD Vidinov, Kalin Nicolaev - Georgiev, Georgi Petrov. “Reoperatif Tiroid Cerrahisinde nüks Ve Morbidite Oranı için Risk faktörleri: Farklı Bir bakış açısı”. Journal of Clinical and Experimental Investigations 4/4 (December 2013), 417-421. https://doi.org/10.5799/ahinjs.01.2013.04.0317.
JAMA Vidinov KN, Georgiev GP. Reoperatif tiroid cerrahisinde nüks ve morbidite oranı için risk faktörleri: farklı bir bakış açısı. J Clin Exp Invest. 2013;4:417–421.
MLA Vidinov, Kalin Nicolaev and Georgi Petrov Georgiev. “Reoperatif Tiroid Cerrahisinde nüks Ve Morbidite Oranı için Risk faktörleri: Farklı Bir bakış açısı”. Journal of Clinical and Experimental Investigations, vol. 4, no. 4, 2013, pp. 417-21, doi:10.5799/ahinjs.01.2013.04.0317.
Vancouver Vidinov KN, Georgiev GP. Reoperatif tiroid cerrahisinde nüks ve morbidite oranı için risk faktörleri: farklı bir bakış açısı. J Clin Exp Invest. 2013;4(4):417-21.