ITERATIVE THYROID-SURGERY - INDICATIONS A ND RESULTS

OBJECTIVES: To analyze the histology results and to assess operative r isk of iterative operations for thyroid surgery. PATIENTS AND METHODS: A total of 249 re-operations were performed in 248 patients over a 6. 5 year period. Two groups of patients were defined according to the in dications for re-operation. Croup 1:80 patients, pathology examination of the surgical specimen discovered thyroid cancer. Croup 2: 169 pati ents, recurrent nodular goitre after an initially benign disease. RESU LTS: In group 1, 14 cancers were bilateral (17.5%) and 7 patients had cervical node metastases (8.8%). In group 2, 19 cancers were discovere d (11.1%), including 5 cases with cervical node invasion (26.3%) and 4 with visceral metastases (21.1%). Twenty complications occurred in 20 patients (8%): compressive cervical hematomas (n = 3, 1.2%), recurren t nerve palsy (n = 7, 2.8%), hypoparathyroidism (n = 9, 3.6%; includin g 3 definitive cases, 1.2%) and mediastinitis (n = 1). These complicat ions were significantly more frequent in patients re-operated for hype rthyroidism or those who had a past history of more than one cervicoto my. CONCLUSION: The frequency of bilateral cancer justifies completing thyroidectomy alter partial thyroidectomy. The rate of definitive com plications after re-operations is greater than first line cervicotomy but is low enough to allow iterative surgery using rigorous procedure in selected patients.