Extent of thyroidectomy in nodular thyroid disease

Citation
I. Songun et al., Extent of thyroidectomy in nodular thyroid disease, EURO J SURG, 165(9), 1999, pp. 839-842
Citations number
13
Categorie Soggetti
Surgery
Journal title
EUROPEAN JOURNAL OF SURGERY
ISSN journal
11024151 → ACNP
Volume
165
Issue
9
Year of publication
1999
Pages
839 - 842
Database
ISI
SICI code
1102-4151(199909)165:9<839:EOTINT>2.0.ZU;2-L
Abstract
Objective: To find out which procedure was the safest for each indication f or operation in diseases of the thyroid gland. Design: Retrospective study. Setting: Two teaching hospitals, The Netherlands. Subjects: 599 consecutive patients who had 601 thyroid operations between 1 October 1985 and 1 June 1993. Main outcome measures: Incidence of complications, particularly postoperati ve hypocalcaemia and injuries to the recurrent laryngeal nerve. Results: Accidental injuries to the recurrent laryngeal nerve occurred in 0 .7% of the nerves at risk (7/948) and the incidence of permanent hypocalcae mia was 5.2% (31/599). In subtotal procedures (bilateral subtotal thyroidec tomy with the remnant left dorsally or total hemithyroidectomy combined wit h subtotal hemithyroidectomy on the other side with a remnant left at the u pper pole) the rate was 11/390 (2.8%) compared with 18/525 (3.4%) after tot al resections. The corresponding numbers of accidental injuries to the recu rrent laryngeal nerve were 2 and 4. Conclusions: Total thyroidectomies are more likely to be done for malignant disease, so the slightly higher complication rates probably reflect the na ture of the disease, which requires more radical resection. Both subtotal p rocedures can be done with comparable low morbidity.