甲状腺全切除术治疗良性甲状腺疾病

V. Naik, Srikanth K. Aithal
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引用次数: 1

摘要

背景:甲状腺全切除术在良性甲状腺疾病治疗中的应用并不普遍。良性甲状腺疾病共行甲状腺全切除术60例。本研究的目的是评估甲状腺全切除术在推定为双侧良性甲状腺疾病患者中的作用,特别强调两种主要术后并发症的发生率,即甲状旁腺功能低下和喉返神经麻痹。方法:本研究为前瞻性研究,选取2016年1月至2018年1月在班加罗尔圣玛莎医院普外科接受甲状腺良性疾病全切除术的患者60例。随访9个月,观察术后并发症。结果:患者以50岁以上年龄组居多,女性多于男性。男女比例为4.5:1。在本研究的60例患者中,一过性复发性单侧喉神经麻痹发生率为5%,暂时性低血钙发生率为20%,永久性低血钙发生率为3.3%,永久性单侧喉神经麻痹发生率为1.66%。经组织病理学检查发现恶性肿瘤的占8.33%。无伤口感染、血肿、双侧RLN麻痹及术后死亡。结论:甲状腺良性病变行全甲状腺切除术可消除甲状腺恶性病变的风险。精细的手术技术可以降低并发症的发生率。甲状腺全切除术是安全的,是治疗双侧良性甲状腺疾病的一种有价值的选择。
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Total thyroidectomy in management of benign thyroid disease
Background: The use of total thyroidectomy in benign thyroid disease treatment is not universal. A total of 60 total thyroidectomies performed for benign thyroid diseases. The Aim of the study was to evaluate the role of total thyroidectomy in patients with presumed bilateral benign thyroid disease, with special emphasis on the incidence of two major post-operative complications namely hypoparathyroidism and recurrent laryngeal nerve palsy. Methods: It was a prospective study, A total of 60 patients who underwent total thyroidectomy for benign thyroid diseases between January 2016 to January 2018 were studied in department of general surgery at St Martha’s hospital, Bangalore. The patients were followed up for a period of nine months for post-operative complications. Results: Most of the patients were in the fifth decade of life, Female outnumbered males. Female: male ratio was 4.5:1. Amongst the 60 patients in the present study, the incidence of transient recurrent unilateral laryngeal nerve palsy was seen in 5 %, temporary hypocalcemia in 20%, permanent hypocalcemia in 3.3%, and permanent unilateral laryngeal nerve palsy in 1.66%. Malignancy detected after histopathological examination was in 8.33% of the patients. There was no wound infection, hematoma, bilateral RLN palsy and post-operative mortality. Conclusion: Total thyroidectomy for benign thyroid disease can eliminate any subsequent risk of malignant change in thyroid glands. A low complication rate can be achieved with meticulous surgical technique. Total thyroidectomy can be performed safely and can be considered as valuable option for treating benign bilateral thyroid diseases.
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