Incidence of Complication in Neartotal ortotalas Compared to Subtotal Thyroidectomy
DOI:
https://doi.org/10.61841/j3ef3033Keywords:
Total thyroidectomy, Near total thyroidectomy, Subtotal thyroidectomy, Recurrent laryngeal nerve injury, HypocalcemiaAbstract
Background: Surgical management of thyroid diseases is still controversial.Complications such as bleeding, hypoparathyroidism and recurrent laryngeal nerve injury (RLNI) represent nearly half of all the complications of thyroid surgery.The latter complication after thyroidectomy, although infrequently encountered, can jeopardize the quality of life.
Total thyroidectomy is the choice for the treatment DTC, benign diseases for eradication of disease, it helps in prevention of recurrence, the facilitation of treatment with radioactive iodine and in eliminating the risk of malignant change in radiated thyroid glands.
Objective:To assess whether the results support that total thyroidectomy is safe and can be considered as the optimal surgical approach for treating benign thyroid diseases.
Patients and Methods:This study was carried out in Baghdad Teaching Hospital during the period from June 2013 to November 2013. It included fifty two (52) patients with different thyroid diseases who underwent different thyroidectomies operations:25 patients who underwent total thyroidectomy(18 patients who underwent primary total thyroidectomy (TT),7 patients who received completion thyroidectomy) (Group 1), 14 patients underwent Near total thyroidectomy (NTT) (Group 2) and 13 patients underwent Subtotal thyroidectomy (STT) (Group 3),so postoperative complication rates regarding hypoparathyroidism and recurrent laryngeal nerve injury(RLNI) were compared.
Results:There is no significant differences in the rate of transient or permanent complications (hypoparathyroidism and RLNI) in TT & NTT as compared to STT.
Conclusions: Total thyroidectomy can be undertaken safely with a low complication rate. There are no significant difference in the rate of postoperative complications associated with total thyroidectomy compared with subtotal thyroidectomy or total.
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References
1. Rosato L, Avenia N, Bernante P, et al. Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on inItaly over 5 years. World J Surg 2004; 28(3):271–276.
2. Bron LP, O’Brien CJ. Total thyroidectomy for clinically benign disease of the thyroid gland. Br J Surg2004;91:569-74.
3. Younes N, Robinson B, Delbridge L. The aetiology, investigationand management of surgical disorders of the thyroid gland.Aust N Z J Surg1996;66:481-90.
4. Aytac B, Karamercan A. Recurrent laryngeal nerve injury and preservation in thyroidectomy. Saudi Med J 2005;26(11):1746-1749.
5. Pattou F, Combemale F, Fabre S, et al. Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg 1998;22:718–724.
6. Nahas ZS, Farrag TY, Lin FR, et al. A safe and cost-effectiveshort hospital stay protocol to identify patients at low riskfor the development of significant hypocalcemia after total thyroidectomy.Laryngoscope 2006;116:906-10.
7. Liao S, Shindo M. Management of well-differentiated thyroid cancer. OtolaryngolClin North Am 2012; 45: 1163-79.
8. Tezelman S, Borucu I, Senyurek Giles Y, et al. The change in surgical practice from subtotal to near-total or total thyroidectomy in the treatment of patients with benign multinodular goiter. World J Surg 2009; 33: 400-5.
9. Friguglietti CU, Lin CS, Kulcsar MA. Total thyroidectomy forbenign thyroid disease. Laryngoscope
2003;113:1820-6.
10. Seiler C A, Glaser C, Wagner H E. Thyroid gland surgery in an endemic region. World J Surg 1996;20:593.
11. Goretzki P E, Simon D, Frilling A, et al. Surgical re intervention for differentiated thyroid cancer. Br J Surg 1993; 80:1009.
12. Pasieka J L, Thompson N W, McLeod M K, et al. The incidence of bilateral well-differentiated thyroid cancer found at completion thyroidectomy. World J Surg 1992; 16:711.
13. Johannes J, Per-Olof A, Linda D L. Alternating from subtotal thyroid resection to total thyroidectomy in the treatment of Graves’ disease prevents recurrences but increases the frequency of permanenthypoparathyroidism. Arch Surg 2012; 397:407-412.
14. Reeve T, Thompson NW. Complications of thyroid surgery: how to avoid them,how to manage them, and observations on their possible effect on the whole patient. World J Surg 2000;24(8):971-975.
15. Bourrel C, Uzzan B, Tison P, et al. Transient hypocalcemia after thyroidectomy.Ann OtolRhinolLaryngol 1993;102(7):496-501.
16. Demeester-Mirkine N, Hooghe L, Van Geertruyden J, et al. Hypocalcemia after thyroidectomy. Arch Surg 1992;127(7):854-858.
17. Eroglu A, Berberoglu U, Buruk F, et al. Completion thyroidectomy for differentiated thyroid carcinoma. J SurgOncol1997; 21: 6.
18. Canbaz H, Dirlik M, Colak T, et al. Total thyroidectomy is safer with identification of recurrent laryngeal nerve. J Zhejiang UnivSci B 2008;9(6):482-488.
19. Echternach M, Maurer CA, Mencke T, et al. Laryngeal complications after thyroidectomy: is it always the surgeon? Arch Surg 2009;144(2):149.
20. Vaiman M, Nagibin A, Olevson J, et al. Complications in primary and completed thyroidectomy. Surg Today 2010; 40: 114-8.
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