CAJ | 학술논문

目的探讨良性甲状腺肿瘤手术复发者是否需行再手术。方法对我院20年间甲状腺再手术94例，第一次手术行术中冰冻检查62例进行分析。结果 94 例甲状腺再手术患者，最初病理诊断：结节性甲状腺肿53例，腺瘤23例，囊腺瘤8例，结节性甲状腺肿合并桥本氏甲状腺炎2例，乳头状腺癌5例，滤泡状腺癌2例，混合性癌1例。行术中冰冻检查的62例中有甲状腺癌2例（3.2％）。未行术中冰冻检查的32例中有6例为甲状腺癌（18. 75％）。在86例良性病变中，再手术复发为恶性者5例（5.8％）。再手术并发症包括：2例短期的喉返神经损伤，2例一过性甲状旁腺功能低下。结论术中冰冻检查可提高诊断的准确率，适当的术式选择可以避免再手术，良性结节的次全切除有利于预防复发。甲状腺再手术是安全的。
목적탐토량성갑상선종류수술복발자시부수행재수술。방법대아원20년간갑상선재수술94례，제일차수술행술중빙동검사62례진행분석。결과 94 례갑상선재수술환자，최초병리진단：결절성갑상선종53례，선류23례，낭선류8례，결절성갑상선종합병교본씨갑상선염2례，유두상선암5례，려포상선암2례，혼합성암1례。행술중빙동검사적62례중유갑상선암2례（3.2％）。미행술중빙동검사적32례중유6례위갑상선암（18. 75％）。재86례량성병변중，재수술복발위악성자5례（5.8％）。재수술병발증포괄：2례단기적후반신경손상，2례일과성갑상방선공능저하。결론술중빙동검사가제고진단적준학솔，괄당적술식선택가이피면재수술，량성결절적차전절제유리우예방복발。갑상선재수술시안전적。
Objective　Most recurrent nodu les of benigh thyroid gland must undergo secondary thyroidectomy． Methods　This pa per reported 94 cases underwent secondar y thyroidectomy during 20-year period in this hospital．Frozen sections were done in 62 cases during the first operations ．Results　Of the 94 cases，the ini tial pat hologic types were nodules goiter in 53 cases，adenoma in 23 cases，cystadenoma in 8 cases，nodules goiter concurrent Hashi moto′s thyroiditis in two cases，pa pill ary adenocarcinoma in five cases，follicu lar adenocarcinoma in two cases，and mixe d carcinoma in one case．There were two c a ses（3.2％） of thyroid carcinoma in frozen section of 62 cases and six cases （18.7 5％） of thyroid carcinoma in non-frozen s ection of 32 cases．Of 86 cases of recurr enr benigh tumor，malignent change develo ped in five cases seen in secodary thyro idectomy．Complications were two transien t palsy of the recurrent laryngeal nerve and two temporary hypoparathyroidism．Co nclusion　Frozen section helps to rai se t he accuracy of diagnosis．Secondary thyro idectomy can be avoided by selecting sui table types of operations．Subtotal thyro i dectomy of benigh nodular thyroid will b e good for preventing reccurence．Seconda y thyroidectomy should be safe procedure．