medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2004, Number 4

<< Back Next >>

Cir Gen 2004; 26 (4)

Systematization of the thyroidectomy technique and its impact on morbidity

Pulido CA, Hurtado LLM, Basurto KE, Cárdenas OA, Muñoz SO, Zaldívar RR, Gómez AM, Humberto Rangel CES

Language: Spanish
References: 20
Page: 286-289
PDF size: 50.48 Kb.


ABSTRACT

Objective: To compare the morbidity of thyroid surgery performed at the Thyroid Clinic of the General Hospital of Mexico with data published in the national and international literature.
Setting: Third level health care hospital.
Patients and methods: Retrospective, observational, comparative study. We analyzed 476 thyroidectomies performed with a systemized technique to treat benign and malignant disease of the thyroid. Studied variables were: Transient, definitive hypocalcemia, hemorrhage, infection, re-operation, tracheostomy, dysphonia, recurrent laryngeal nerve lesion, and mortality. Central tendency measures and Chi square test were used for the analysis.
Results: Average age was of 50.5 years in 436 women and 40 men; 250 (38.2%) total thyroidectomies, 68 (27.2%) of them accompanied by radical modified neck dissection (RMD) were performed, as well as 29 (6.6%) subtotal thyroidectomies and 197 (41.3) hemithyroidectomies. We encountered 4 (0.8%) definitive hypocalcemia cases, 8 (1.6%) recurrent laryngeal nerve lesions, and 38 (8%) lesions of the superior laryngeal nerve. Comparing these results with the national and world literature places us below the international parameters.
Conclusion: In our series, complications are within the ranges reported worldwide.


REFERENCES

  1. Pulido-Cejudo A, Cárdenas-del Olmo A, Basurto-Kuba E, Garza-Flores JH, Reyes Hernández L, Muñoz-Solís O, et al. Complicaciones de la cirugía de tiroides. Cir Gen 1998; 20: 102-105.

  2. Hurtado-Lopez LM, Zaldivar-Ramirez FR, Basurto-Kuba E, Pulido-Cejudo A, Garza-Flores JH, Muñoz-Solis O, et al. Causes for early reintervention after thyroidectomy. Med Sci Monit 2002; 8: 247-50.

  3. Hurtado-Lopez LM, Pulido-Cejudo A, Basurto-Kuba E. Puntos clave para una adecuada y segura identificación del nervio laríngeo recurrente durante la tiroidectomía. Aplicación en 100 tiroidectomías. Cir Gen 1998; 20: 95-8.

  4. Hurtado-López LM, Pulido-cejudo A, Zaldivar-Ramirez FR, Basurto-Kuba E. A propósito de la localización del nervio laríngeo recurrente y las glándulas paratiroides inferior en la cirugía de tiroides. Como lo hago yo. Cir Gen 2000; 22: 283-6.

  5. Hurtado-López LM, López-Romero S, Rizzo-Fuentes C, Zaldivar-Ramírez FR, Cervantes-Sánchez C. Selective use of drains in thyroid surgery. Head Neck 2001; 23: 189-93.

  6. Hurtado-Lopez LM, Zaldivar-Ramirez FR. Risk of lesion to the external branch of the superior laryngeal nerve. Laryngoscope 2002; 112: 626-9.

  7. Fewins J. Complications of thyroid and parathyroid surgery. Otolaryngol Clin North Am 2003; 36: 189-206.

  8. Zarnegar R. Prevention, evaluation, and management of complications following thyroidectomy for thyroid carcinoma. Endocrinol Metab Clin North Am 2003; 32: 483-502.

  9. Havas T. Unilateral vocal fold paralysis: causes, options and outcomes. Austr N Z J Surg 1999; 69: 509-13.

  10. Steurer M. Advantages of recurrent laryngeal nerve identification in thyroidectomy and parathyroidectomy and the importance of preoperative and postoperative laryngoscopic examination in more than 1,000 nerves at risk. Laryngoscope 2002; 112: 124-33

  11. Bergamaschi R. Morbidity of thyroid surgery. Am J Surg 1998; 176: 71-5

  12. Chow TL. Outcomes and complications of thyroid surgery: retrospective study. HKMJ 2001; 7: 261-5.

  13. Songun I. Complications of thyroid surgery. En: Clark OH, Duh Qy, editors. Textbook of Endocrine Surgery. Philadelphia, W.B. Saunders; 1997: 167-74.

  14. Shaha AR. Selective use of drains in thyroid surgery. J Surg Oncol 1993; 52: 241-3.

  15. Abbas G. Re-operation for bleeding after thyroidectomy and parathyroidectomy. Head Neck 2001; 23: 544-6.

  16. Shaha AR. Practical management of post-thyroidectomy hematoma. J Surg Oncol 1994; 57: 235-8.

  17. Crookes PF. Injury to the superior laryngeal branch of the vagus during thyroidectomy: lesson or myth? Ann Surg 2001; 233: 588-93.

  18. Rodríguez CS, Labastida AS, Olano NO, Muñoz CML. Morbilidad debida a tiroidectomía por cáncer. Cir Gen 1996; 18: 92-7.

  19. Bhattacharyya N. Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngol Head Neck Surg 2002; 128: 389-392.

  20. Sosa JA, Bowman H, Tielsch JM, Powe NR, Gordon TA, Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg 1998; 228: 320-30.




2020     |     www.medigraphic.com