Abstract:Objective:To discuss the proper selection of reoperative method for recurrent nodular goiter to reduce the incidence of major operative complications.
Methods :The clinical data of 68 cases with recurrent nodular goiter treated by operation were retrospectively analyzed. Among them, 56 cases had a single recurrence,10 cases had two recurrences, and 2 cases had three recurrence after the initial operation.
Results:The mean operative time was 136.43min,and the mean operative blood loss was 212.33mL. Unilateral total or neartotal lobectomy and contralateral subtotal or partial lobectomy was performed in 12 cases,unilateral subtotal lobectomy and contralateral subtotal or partial lobectomy was performed in 28 cases,unilateral subtotal lobectomy was performed in 20 cases,and unilateral partial lobectomy was performed in 8 cases.The recurrent laryngeal nerves were exposed in 54 cases of the 68 cases. After reoperation,one patient had paralysis of bilateral vocal cords,and tracheotomy was done;in another case, the left recurrent larynageal nerve was injured.Four patients had transient numbness of extrementies.
Conclusions:The reoperation of choice for recurrent thyroid nodular goiter is unilateral total lobectomy or at least subtotal or nearly total lobectomy, and the partial resection operation should be abandoned.