갑상선의 일차 수술과 재수술에서 합병증 발생의 비교

Abstract

Background and Objectives: Thyroid reoperation had been denied for fear of an increased risk of major complications such as recurrent laryngeal nerve injury, superior laryngeal nerve injury and hypoparathyroidism. The purpose of this article is to review the safety of completion thyroidectomy. Materials and Methods: We collected 33 cases of reoperative thyroid surgery and 309 cases of initial thyroid surgery, which performed at the Department of Otolaryngology, Head and Neck Surgery of Kosin Medical College Hospital from april 1998 to january 2002. And retrospective studies included extent of initial thyroidectomy and pathologic report, interval between initial surgery and reoperation, and complication rate. Results: When the unilateral lobectomy was performed for surgical management of differentiated thyroid carcinoma, reoperation rate was five times larger than when subtotal thyroidectomy was performed. Transient recurrent laryngeal nerve injury and permanent recurrent laryngeal nerve injury were occurred in 1 each case (3%), transient hypoparathyroidism was occurred in 2 cases, but permanent hypoparathyroidism was not developed. Complication rate of thyroid reoperation was not so high compared with initial thyroid surgery. Conclusion: As a development of diagnostic methods, rates of thyroid reoperation were increased. But the adequate extent of initial surgery can reduce the rate of recurrence of thyroid disease. If surgeon had sufficient anatomical knowledge and meticulous surgical technique, reoperative thyroid surgery can be performed with minimal morbidity and low rate of complications. (J Clinical Otolaryngol 2003;14:269-274)