F. Menegaux et al., Secondary thyroidectomy in patients with prior thyroid surgery for benign disease: A study of 203 cases, SURGERY, 126(3), 1999, pp. 479-483
Background. The goal of this study was to evaluate the complication rate of
secondary thyroidectomy in patients with prior thyroid surgery for benign
disease.
Methods. Over an 8-year period, 203 thyroid reoperations were performed on
202 patients. All information relating to operative procedures, pathology,
and complications was recorded prospectively.
Results. There were 24 men and 178 women with a mean age of 52 years. Prior
surgery was unilateral in 136 cases (67%) and bilateral in 67 cases (33%),
and 14 patients (6.9%) had more than 1 previous thyroid operation. For eut
hyroid or pretoxic recurrent nodular goiter, 190 reoperations were performe
d and 13 reoperations were performed for recurrent thyrotoxicosis. Twenty-t
hree cancers were found in a specimen (11.4%). Completion thyroidectomy was
done in 143 patients. Postoperative complications occurred in 21 patients
(10.4%): recurrent laryngeal nerve palsy (7 patients), hypocalcemia (8 pati
ents), hematoma requiring surgical evacuation (5 patients), and wound infec
tion (1 patient). Complications remained permanent in 4 patients (2%).
Conclusions. The permanent complication rate is higher in thyroid reoperati
ons than in primary thyroid operations. However, we believe that this 2% ra
te is low enough to allow reoperation whenever it is necessary, provided pr
ecise operative rules are respected.