Endemik Bir Bölgede 940 Tiroidektomi Olgusunun Değerlendirilmesi: Tek Merkez, Tek Cerrah Deneyimi

Yıl 2016, Cilt: 13 Sayı: 3, 207 - 214, 30.12.2016

Mehmet Tolga Kafadar

Öz

Amaç: Tiroidektomi tüm dünyada olduğu gibi, ülkemizde de genel cerrahi ve endokrin cerrahisi
kliniklerinde en çok gerçekleştirilen ameliyatlardandır. Bu çalışmada, yeni uzman olmuş bir hekimin,
endemik guatr bölgesi olan Bitlis ilindeki tiroidektomi deneyimlerinin irdelenmesi amaçlandı.
Hastalar ve Yöntem: Bitlis Devlet Hastanesinde, Eylül 2008 ve Mart 2015 tarihleri arasında nodüler guatr
ön tanısıyla cerrahi endikasyonu konulan ve tek cerrah tarafından tiroidektomi yapılan toplam 940 hasta
retrospektif olarak değerlendirildi. Hastalar yaş, cinsiyet, uygulanan cerrahi teknik, komplikasyonlar ve
patoloji sonuçları açısından irdelendi.
Bulgular: Hastalarımızın 827' si (%88) kadın, 113' ü (%12) erkek olup, kadın/erkek oranı 7,3/1 idi. Toplam
940 hastanın 30' una (%3,2) bir taraf total + diğer taraf totale yakın, 910' nuna (%96,8) bilateral total
tiroidektomi uygulandı. Komplikasyonlara bakıldığında, 3 (%0,3) hastada kanama, 8 (%0,8) hastada yara
yeri enfeksiyonu, 17 (%1,8) hastada seroma, 4 (%0,4) hastada sütür reaksiyonu, 58 (%6,1) hastada geçici
hipokalsemi, 6 (%0,6) hastada kalıcı hipokalsemi, 13 (%1,3) hastada geçici rekürren sinir hasarı görüldü. 51
(%5,4) hastada malignite tespit edildi. Kalıcı rekürren sinir hasarı ve mortalite izlenmedi.
Sonuç: Yapılan ameliyatların sayısının artması ve tecrübe kazanılmasıyla, total tiroidektominin kabul
edilebilir komplikasyon oranları ile güvenle yapılabileceğine inanıyoruz. Nodüler guatr hastalarında total
tiroidektomi, nüks ve reoperasyona bağlı komplikasyon ve malignite riskini ortadan kaldırdığı için tercih
edilmelidir.

Anahtar Kelimeler

Endemik Guatr, Tiroidektomi, Postoperatif Komplikasyonlar

Evaluation of 940 thyroidectomy cases in an endemic region: Single center, single surgeon experience

Öz

Objective: As in the most countries of the world including Turkey, thyroidectomy is one of the frequently
performed surgeries in general surgery and endocrinology clinics. In this study, the discussion of the
thyroidectomy experiences of a medical doctor who just completed his residency is intended in Bitlis city, the
region where goiter is endemic.

Material and methods: 940 patients with surgery indication according to nodular goiter diagnosis
underwent thyroidectomy by a single surgeon were evaluated retrospectively at Bitlis State Hospital between
September 2008 and March 2015. Patients were evaluated in terms of age, gender, surgical technique,
complications and pathology results.
Results: 827 of our patients (88%) were female and 113 (12%) were male. The proportion of female to male
patients was 7,3/1. 30 of 940 patients (3,2%) underwent one part total and the other part near total
thyroidectomy and 910 patients (96,8%) underwent total thyroidectomy. Regarding to complications, there
were 3 patients (0,3%) with postoperative hematoma, 8 patients (0,8%) with wound infection, 17 patients
(1,8%) with seroma, 4 patients (0,4%) with suture reaction, 58 patients (6,1%) with temporary
hypocalcaemia, 6 patients (0,6%) with permanent hypocalcaemia, 13 patients (1,3%) with temporary
recurrent nerve paralysis. At 51 patients (5,4%) malignancy was determined. Permanent recurrent nerve
paralysis and mortality were not seen.
Conclusion: We believe that total thyroidectomy can be performed safely with acceptable complication
ratios as the surgery and experience rates increase. Total thyroidectomy should be preferred in patients with
nodular goiter as it extinguishes the risks of recurrence and malignancy and complication risks of
reoperation. 

Anahtar Kelimeler

Endemic Goiter, Thyroidectomy, Postoperative Complications

Kaynakça

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