CAJ | 학술논문

目的探讨双侧甲状腺全切除/近全切除术治疗双侧结节性甲状腺肿是否安全可行.方法 2003年1月至2006年12月311例拟诊双侧结节性甲状腺肿者分为A、B两组;A组130例行双甲全/近全切术;B组181例行双甲次全切或/和大部切除术.结果 A、B两组各有6例和2例术中冰冻报告良性,但术后石蜡切片报告为乳头状癌.A组不需再手术,B组需再手术;两组术后各3例(2.42%,3/124 vs.1.68%,3/179)有暂时性声嘶,差异无统计学意义(P=0.48).术后2月A组2例有音调改变,无法发高音,喉镜示双侧声带活动好;B组1例有声嘶,喉镜示一侧声带活动减弱.两组术后各有11(8.87%,11/124)和9例(5.03%,9/179)术后48 h内有低钙血症,差异无统计学意义(P=0.16).两组无永久性甲状旁腺功能减退.B组术后2例(1.12%,2/179)因出血需再手术.A组术后无结节性甲状腺肿复发,B组12例复发(6.70%,12/179),差异有统计学意义(P=0.02).结论双甲全/近全切除术可减少结节性甲状腺肿术后复发率和再手术率,且并发症并无增加,是安全可行的.
목적 탐토쌍측갑상선전절제/근전절제술치료쌍측결절성갑상선종시부안전가행.방법 2003년1월지2006년12월311례의진쌍측결절성갑상선종자분위A、B량조;A조130례행쌍갑전/근전절술;B조181례행쌍갑차전절혹/화대부절제술.결과 A、B량조각유6례화2례술중빙동보고량성,단술후석사절편보고위유두상암.A조불수재수술,B조수재수술;량조술후각3례(2.42%,3/124 vs.1.68%,3/179)유잠시성성시,차이무통계학의의(P=0.48).술후2월A조2례유음조개변,무법발고음,후경시쌍측성대활동호;B조1례유성시,후경시일측성대활동감약.량조술후각유11(8.87%,11/124)화9례(5.03%,9/179)술후48 h내유저개혈증,차이무통계학의의(P=0.16).량조무영구성갑상방선공능감퇴.B조술후2례(1.12%,2/179)인출혈수재수술.A조술후무결절성갑상선종복발,B조12례복발(6.70%,12/179),차이유통계학의의(P=0.02).결론 쌍갑전/근전절제술가감소결절성갑상선종술후복발솔화재수술솔,차병발증병무증가,시안전가행적.
Objective To evaluate the safety and rationality of total/near total bilateral thyroidectomy(TBT) for patients with bilateral multinodular goiter(BMG). Methods From January 2003 to December 2006,311 BMG cases were preoperatively divided into two groups, 130 cases in group A underwent TBT, and 181 cases in group B were treated with subtotal/partial bilateral thyroidectomy. Results There were 6 and 2 eases in group A and group B respectively diagnosed by intraoperative frozen biopsy as BMG, but identified as papillary carcinoma by final pathology. Hence the 6 cases in group A avoided reoporation, while the 2 cases in group B underwent a resection of the remnant gland. Transient hoarseness developed in 3 (2.42%, 3/124) and 3 (1.68%, 3/179) eases in group A and group B respectively (P =0.48). Transient hypocalcemia developed in 11 (8.87% ,11/124) and 9(5.03% ,9/179) cases in group A and group B respectively(P =0.16). There was no postoperative goiter recurrence in group A, but recurrence developed in 12 cases (6.70%,12/179) in group B(P=0.02). Conclusions Total bilateral thyroidectomy is safe and rational for the management of bilateral thyroid goiter.