甲状腺疾病的再次手术治疗

Reoperation for thyroid diseases

目的近年来甲状腺疾病再手术比例呈明显增加趋势,与初次手术相比,再手术者并发症发生率明显增高。文中探讨甲状腺再手术指征、危险性及其相关因素。方法对77例甲状腺再手术患者进行回顾性分析。结果术后早期再手术者23例(29.9%),主要原因为甲状腺癌切除不彻底。术后晚期再手术者54例(70.1%),主要原因为良性疾病术后复发和恶性肿瘤复发。喉返神经损伤6例(7.8%),甲状旁腺功能低下5例(6.5%),乳糜漏2例(2.6%)。结论甲状腺再手术适用于各种甲状腺良、恶性疾病,因其术后并发症较高,首次手术时应尽可能考虑设计周全,尽量避免再手术。

Objective The proportion of reoperation for thyroid diseases is on the increase,and the rate of its complications is markedly higher than that of the primary surgery.This study aimed to investigate the indications,risks and other factors associated with reoperation for thyroid diseases.Methods We retrospectively analyzed the clinical data of 77 cases of thyroid disease treated by reoperation in our department from January 2005 to December 2008.Results Twenty-three of the cases（29.9%） underwent reoperation for the incomplete resection of thyroid carcinoma 1-30 days after the primary surgery,and the other 54（70.1%） for the recurrence of benign or malignant thyroid tumor 31-365 days after it.Post-operative complications included recurrent laryngeal nerve palsy in 6 cases（7.8%）,hypoparathyroidism in 5（6.5%） and chylous leakage in 2（2.6%）.Conclusion Reoperations are indicated for both benign and malignant thyroid diseases,but they generally expose the patients to a higher risk of complications.So every effort should be made in the initial operation to avoid a second one.