Secondary thyroidectomy in patients with prior thyroid surgery for benign disease: a study of 203 cases

Surgery. 1999 Sep;126(3):479-83.

Abstract

Background: The goal of this study was to evaluate the complication rate of secondary thyroidectomy in patients with prior thyroid surgery for benign disease.

Methods: Over an 8-year period, 203 thyroid reoperations were performed on 202 patients. All information relating to operative procedures, pathology, and complications was recorded prospectively.

Results: There were 24 men and 178 women with a mean age of 52 years. Prior surgery was unilateral in 136 cases (67%) and bilateral in 67 cases (33%), and 14 patients (6.9%) had more than 1 previous thyroid operation. For euthyroid or pretoxic recurrent nodular goiter, 190 reoperations were performed and 13 reoperations were performed for recurrent thyrotoxicosis. Twenty-three cancers were found in a specimen (11.4%). Completion thyroidectomy was done in 143 patients. Postoperative complications occurred in 21 patients (10.4%): recurrent laryngeal nerve palsy (7 patients), hypocalcemia (8 patients), hematoma requiring surgical evacuation (5 patients), and wound infection (1 patient). Complications remained permanent in 4 patients (2%).

Conclusions: The permanent complication rate is higher in thyroid reoperations than in primary thyroid operations. However, we believe that this 2% rate is low enough to allow reoperation whenever it is necessary, provided precise operative rules are respected.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Goiter, Nodular / surgery
  • Hematoma / etiology
  • Humans
  • Hypocalcemia / etiology
  • Laryngeal Nerve Injuries
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Prospective Studies
  • Recurrence
  • Reoperation / adverse effects
  • Surgical Wound Infection / etiology
  • Thyroid Diseases / surgery*
  • Thyroid Neoplasms / surgery
  • Thyroidectomy / adverse effects*
  • Thyrotoxicosis / surgery