Evaluation of different surgical procedures for bilateral multiple thyroid nodules
10.3760/cma.j.issn.1674-6090.2011.04.014
- VernacularTitle:双侧甲状腺多发结节手术方式探讨
- Author:
Haipeng GUO
;
Xihong YANG
;
Muyuan LIU
;
Jianying LIN
;
Weizheng CHEN
;
Hanwei PENG
- Publication Type:Journal Article
- Keywords:
Bilateral multiple thyroid nodules;
Thyroid neoplasms;
Total thyroidectomy;
Hypoparathyroidism
- From:
Journal of Endocrine Surgery
2011;05(4):260-263
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo compare the exposure, identification of parathyroid and postoperative complications between total thyroidectomy (TT) and subtotal/near total thyroidectomy (S/NT) for bilateral multiple thyroid nodules. MethodsA total of 278 cases were performed TT and S/NT randomly from Dec. 2006 to Dec.2009. The histology, identification of parathyroid and recurrent laryngeal nerves (RLN), and incidence of complications were compared between the 2 surgical procedures. The data were processed with t test or x2 test.Results227 cases were estimated to be benign preoperatively, among whom 28 cases ( 12.3％ ) were diagnosed as focal cancer by postoperative pathology. The identification rate of parathyroid was 96.5％ in TT group and 60.4％ in S/NT group (P＜0.05). The mean postoperative serum calcium level was 2.057 +0.016 mmol/L in TT group and 2. 15 + 0.019 mmol/L in S/NT group (P ＜ 0.05 ). The incidence rate of transient hypoparathyroidism (HPT) was 16.9％ in TT group and 5.7％ in S/NT group (P＜0.05). There was no statistical difference between the 2 groups in terms of the incidence rate of permanent HPT and transient recurrent laryngeal nerves (RLN) palsy ( P ＞ 0.05 ). The incidence rate of permanent HPT was higher in reoperation cases ( 11.1％ ) than in primary surgery cases (0.0％) in TT group ( P ＜0.05 ). ConclusionBased on the accurate technique under microscope field, TT is a safe surgical procedure for primary surgery with bilateral multiple thyroid nodules.
