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6 - Comparison of early and late results of total and subtotal thyroidectomy for benign thyroid disease
Kemal Arslan, Ersin Turan, Mehmet Ali Eryılmaz, Emet Ebru Nazik, Osman Doğru
Background: Recently, total thyroidectomy (TT) has been performed and suggested in benign thyroid disease. But it was reported that the complications of total thyroidectomy was more than bilateral subtotal thyroidectomy (BST) this is still a topic of debate. Purpose of the present study is comparison of complications of BST and TT operations in treatment of benign thyroid disease.
Materials and Methods: Early and late complications of TT and BST operations were retrospectively evaluated, which were performed in General Surgery Clinic of Konya Training and Research Hospital inbetween 2004-2008.
Results:The study involved 96 patients in BST group and 110 patients in TT group. Follow-up period was 69.4±8.3 months in BST group, 52.7±5.3 months in TT group.Transient hypocalcemia were detected in 10 patients (9.1%) in BST group and 7 patients (7.3%) in TT group. Transient recurrent laryngeal nerve paralysis developed in 12 patients (7.2%); 5 patients (5.2%) in BST group and 7 patients (6.4%) in TT group. Hematoma in 4 patients (4.2%), seroma in 3 patients (3.1%), flap edema in 5 patients (5.2%) occured in BST group. In TT group, there had been; hematoma in 1 patients (1.0%), seroma in 5 patients (4.5%), flap edema in 4 patients (4.5%).
Permanent hypocalcemia occured in 2 patients (2.1%) in BST group and 3 patients (2.7%) in TT group. Permanent recurrent laryngeal nerve paralysis developed in 1 patient (1.0%) in BST group and 2 patients (1.5%) in TT group. There was no statistically significant difference inbetween the groups about complications and demographic characteristics. Recurrence was seen in 6 patients (6.3%) in BST group.
Discussion and Conclusion: TT not increase early and late complications in bengn thyroid diease requiring sugery. BSThas arisk of recurrenceaftersurgeryand thereforemust be carried outagain.Complications in secondary thyroidectomy in patients with prior thyroid surgery are very high.Therefore, if surgery is necessary in benign thyroid diseases should be TT.
Keywords: Subtotal thyroidectomy, total thyroidectomy, paralysis of recurrent laryngeal nerve, hypocalcemia
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