Strategy to prevent complications in reoperation of differentiated thyroid carcinoma

VernacularTitle:分化型甲状腺癌再手术的并发症预防
Author: Chunhua LI ; Zhaohui WANG ; Jin CHEN ; Jianchao CHEN
Keywords: Differentiated thyroid carcinoma (DTC); Reoperation; Recurrent laryngeal nerve; Hypoparathyroidism
From: Chinese Journal of Endocrine Surgery 2017;11(4):294-295,315
CountryChina
Language:Chinese
Abstract: Objective To discuss the preventive strategy of complications in reoperation of differentiated thyroid carcinoma (DTC).Method Clinical data of 114 patients with DTC who needed reoperation because of recurrence or inadequate operation were reviewed retrospectively.The reoperations included total thyroidectomy for 101 cases,lobectomy for 13 cases,central compartment neck dissection for 94 cases,and lateral neck dissec tion for 65 cases.Results 8 cases (8.77％) suffered from temporary RLN injury,one patient (0.88％) has permanent nerve palsy.Nerve dysfunction recovered after reoperation in 4 cases who had suffered from recurrent laryngeal nerve palsy in previous operations.Transient hypoparathyroidism occured in 10 patients (8.77％),and per manent hypoparathyroidism happened to 2 patients (1.75％).Conclusion For patients undergoing reoperation,detailed preoperative examination,proper operative approach,meticulous dissection on the thyroid capsule,visual identification of RLN followed anatomic landmark and intraoperative nerve monitoring (IONM) are key factors to reduce complications in reoperation of DTC.