Reoperative Surgery for Benign Thyroid Diseases

• Authors: Piero Alesina , Thomas Rolfs , Martin Walz
• Languages of publication: EN

Abstracts

EN

The aim of the study was to present a retrospective analysis of the experience with completion thyroidectomy for benign thyroid disease in a referral centre.Material and methods. Between October 1999 and December 2007, 2353 thyroid operations were performed for benign diseases. Of these, 113 patients (12 men, 101 women; age: 25-77 years) underwent a reoperation for recurrent goitre (n=107) or recurrent Grave's disease (n=6). A bilateral resection was performed in 33 patients, a unilateral in 80 patients. The mean interval between the initial and the reoperative procedure was 14.5 years.Results. The mean operative time was 78 minutes (range: 20-210) with 68 minutes for unilateral and 96 minutes for bilateral operations. Postoperative complications consisted of transient hypoparathyroidism in 6 patients (5.3%); no patient experienced a permanent hypoparathyroidism. A transient recurrent laryngeal nerve (RLN) palsy occurred in 6 cases (4.1% of "nerves at risk") and a definitive bilateral RLN palsy was registered in a patient with a preoperative unilateral RLN palsy (0.9%). In 4 patients (3.5%) a postoperative bleeding required reoperation. No wound infection was observed. The mean postoperative hospital stay was 2.3 days. Final histology showed a thyroid cancer in 6 patients (5.3%).Conclusion. In experienced hands, reoperative thyroid surgery can be performed safely and with limited morbidity.

Keywords

EN

thyroid surgery; thyroidectomy; recurrence; results; complications; follow-up

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2008
• Volume: 80
• Issue: 9
• Pages: 441-445

Dates

published

1 - 9 - 2008

online

25 - 9 - 2008

Contributors

author

Piero Alesina

• Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Akademisches Lehrkrankenhaus der Universität Duisburg, Essen

author

Thomas Rolfs

• Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Akademisches Lehrkrankenhaus der Universität Duisburg, Essen

author

Martin Walz

• Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Akademisches Lehrkrankenhaus der Universität Duisburg, Essen

References

• Gough IR, Wilkinson D: Total thyroidectomy for management of thyroid disease. World J Surg 2000; 24:962-65.
• Berghout A, Wiersinga WM, Drexhage HA et al.: The long-term outcome of thyroidectomy for sporadic non-toxic goitre. Clin Endocrinol 1989; 31: 193-199.
• Pasieka JL, Thompson NW, McLeod MK et al.: The incidence of bilateral well-differentiated thyroid cancer found at completion thyroidectomy. World J Surg 1992; 16: 711-16.
• Visset J, Lumingu K, Le Bodic MF et al.: Chirurgie 1991; 117: 37-42.
• Chao TC, Jeng LB, Lin JD et al.: Reoperative thyroid surgery. World J Surg 1997; 21: 644-47.
• Levin KE, Clark AH, Duh QY et al.: Reoperative thyroid surgery. Surgery 1992; 111: 604-09.
• Menegaux F, Turpin G, Dahman M et al.: Secondary thyroidectomy in patients with prior thyroid surgery for benign disease: a study of 203 cases. Surgery 1999; 125: 479-83.
• Hsu B, Reeve TS, Guinea AI et al.: Recurrent substernal nodular goiter: incidence and management. Surgery 1996; 120: 1072-75.
• Müller PE, Jakoby R, Heinert G et al.: Surgery for recurrent goitre: its complications and their risk factors. Eur J Surg 2001; 167: 816-21.
• Makeieff M, Rubinstein P, Youssef B et al.: Repeat surgery for thyroid nodules (excluding cancer and hyperthyroidism). Ann Chir 1998; 52: 970-77.
• Wilson DB, Staren ED, Prinz RA: Thyroid reoperations: indications and risks. Am Surg 1998; 64: 674-79.
• Reeve TS, Delbrige L, Brady P et al.: Secondary thyroidectomy: a twenty-years experience. World J Surg 1988; 12: 449-53.
• Peix JL, Van Box Som P, Olagne E et al.: Results of reoperation for goiter. Ann Chir 1997; 51: 217-21.
• Calabro S, Auguste LJ, Attie JN: Morbidity of completion thyroidectomy for initially misdiagnosed thyroid carcinoma. Head Neck Surg 1998; 10: 235-38.
• Goretzki PE, Simon D, Frilling A et al.: Surgical reintervention for differentiated thyroid cancer. Br J Surg 1993; 80: 1009-12.
• Lefevre JH, Tresallet C, Leenhardt L et al.: Reoperative surgery for thyroid disease. Langenbeck Arch Surg 2007; 392: 685-91.
• De Jong SA, Demeter JG, Lawrence AM et al.: Necessity and safety of completion thyroidectomy for differentiated thyroid carcinoma. Surgery 1992; 112: 734-37.
• Beahrs OH, Vandertoll DJ: Complications of secondary thyroidectomy. Surg Gynecol Obstet 1963; 117: 117-19.
• Thomas CG: Invited Commentary. World J Surg 1988; 12: 452.
• Clark OH: Total thyroidectomy: the preferred option for multinodular goiter. Ann Surg 1988; 208: 244-45.
• Delbrige L, Guinea AI, Reeve TS: Total thyroidectomy for benign bilateral multinodular goiter. Effect of changing practice. Arch Surg 1999; 134: 1389-93.
• Rios-Zambudio A, Rodriguez J, Riquelme J et al.: Prospective study of postoperative complications after total thyroidectomy for multinodular goiter by surgeons with experience in endocrine surgery. Ann Surg 2004; 240: 18-25.
• Gibelin H, Sierra M, Mothes D et al.: Risk factor for recurrent nodular goiter after thyroidectomy for benign disease: case-control study of 224 patients. World J Surg 2004; 28: 1079-82.

Identifiers

DOI

10.2478/v10035-008-0064-8