复发性结节性甲状腺肿的再手术治疗(附126例病例分析)

Reoperation for Recurrent Nodular Goiter-A Report of 126 Cases

目的:探讨复发性结节性甲状腺肿再次手术的方式,以降低手术复发率。方法:回顾性的分析手术治疗的76例复发性结节性甲状腺肿患者的临床资料。其中1次术后复发者73例,2次术后复发者3例。结果:单纯结节切除3例,一侧部分切5例,一侧次全切7例,双侧部分切14例,一侧次全加对侧部分切28例,双侧次全切19例。声音嘶哑3例,手足搐搦4例,甲状腺功能低下2例。结论:再次手术时,首选一侧腺叶的全切除、对侧次全切或部分切除。

Objective：To investigate the reoperative method for recurrent nodular goiter to reduce the incidence of major operative complicatons.Methods：The clinical data of 76 cases with recurrent nodular goiter treated by operation were retrospectively analyzed.Among them,73 cases had a single recurrence.3 cases had tow recurrences.Results：Previous surgery included unilateral glandectomy in 3 cases.Unilateral total or near-total lobectomy and contralateral subtotal or partial lobectomy was performed in 28 cases,partial lobectomy Was performed in 14 caes,unilateral subtotal lobectomy and contralateral subtotal or partial lobectomy Was performed in 19 cases,unilateral subtotal lobectomy was performed in 7 cases,and unilateral pattial lobectomy was performed in 8 cases.After reoperation.3 patient had paralysis of bilateral vocal cords,4 patients had transient numbness of extrementies,hypothyroidism in 2 cases.Conclusion：The reoperation of choice for recurrent thyroid goiter is unilateral total lobectomy or at least subtotal or nearly total Lobectomy.