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

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

Keywords

• Goiter, recurrence, nodular goiter, thyroid gland, recurrent laryngeal nerve palsy, hypoparathyroidism

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

Öz

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

Anahtar Kelimeler

• Guatr, nüks, nodüler guatr, tiroid bezi, tekrarlayan laringeal sinir felci, hipoparatiroidi

Kaynakça

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