Study on Safety of Total Thyroidectomy in Differentiated Thyroid Carcinoma (Report of 72 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Ji , GUAN Xiaoqing , WU Jianqiang , CHEN Yan , WU Jisheng , GU Shucheng , ZHENG Xiangxin.

Department of Endocrine Surgery, Suqian People’s Hospital, Nanjing Drum-Tower Hospital Group, Suqian 223800, Jiangsu Province, China;

Corresponding author：

Keywords：

Total thyroidectomy; Differentiated thyroid carcinoma; Laryngeal recurrent nerve injury; Hypoparathyroidism

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ObjectiveTo explore the safety-related factors for total thyroidectomy in differentiated thyroid carcinoma. MethodsThe clinical data of 72 patients with differentiated thyroid carcinoma treated by total thyroidectomy from January 2002 to January 2010 were retrospectively analyzed, the laryngeal recurrent nerve injury and hypoparathyroidism were observed. ResultsThe incidences of hypoparathyroidism and laryngeal recurrent nerve injury were 15.28% （11/72) and 4.17%（3/72）, respectively. The hypoparathyroidism was significantly related to the thyroid reoperation, the lymph nodes metastases of central compartment, or the extraglandular invasion of the primary tumor (P lt;0.05), but not to the dissection of neck lymph nodes (P gt;0.05). The laryngeal recurrent nerve injury was not relative to those factors (P gt;0.05). ConclusionThe safetyrelated factors of total thyroidectomy in differentiated thyroid carcinoma include thyroid reoperation, the lymph node metastasis of central compartment, and the extraglandular invasion of the primary tumor.

Citation： WU Ji,GUAN Xiaoqing,WU Jianqiang,CHEN Yan,WU Jisheng,GU Shucheng,ZHENG Xiangxin.. Study on Safety of Total Thyroidectomy in Differentiated Thyroid Carcinoma (Report of 72 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(5): 541-544. doi: Copy

1.	向俊, 吴毅. 甲状腺癌临床诊治新特点(附572例临床分析) [J]. 中国实用外科杂志, 2008, 28(5): 365367.
2.	郑泽霖, 孙辉, 盖宝东. 甲状腺疾病外科治疗的热点和难点 [J]. 中国普外基础与临床杂志, 2008, 15(5): 307310.
3.	任国胜, 苏新良. 分化型甲状腺癌颈淋巴结清扫术式的选择 [J]. 中国普外基础与临床杂志, 2010, 17(8): 765767.
4.	Mitchell I, Livingston EH, Chang AY, et al. Trends in thyroid cancer demographics and surgical therapy in the United States [J]. Surgery, 2007, 142(6): 823828.
5.	徐少明. 对甲状腺癌应慎行甲状腺全切术 [J]. 中国普外基础与临床杂志, 2009, 16(5): 344347.
6.	刘永锋. 加强分化型甲状腺癌的规范化治疗 [J]. 中国普外基础与临床杂志, 2009, 16(5): 341343.
7.	Frank R, Vandervelde TL, Doherty GM, et al. Mangement of nodular thyroid disease and thyroid cancer associated with neck irradiation [J]. Probl Ceneral Surg, 2007, 14(6): 2731.
8.	Kahky MP, Weber RS. Complications of surgery of the thyroid and parathyroid glands [J]. Surg Clin North Am, 1993, 73(2): 307321.
9.	Wagner HE, Seiler C. Recurrent laryngeal nerve palsy after thyroid gland surgery [J]. Br J Surg, 1994, 81(2): 226228.
10.	Wheeler MH. The technique of thyroidectomy [J]. J R Soc Med, 1998, 91(Suppl 33): 1216.
11.	Fardella C, Jiménez M, González H, et al. Pathological characteristics of thyroid microcarcinoma. A review of 402 biopsies [J]. Rev Med Chil, 2005, 133(11): 13051310.
12.	Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 19732002 [J]. JAMA, 2006, 295(18): 21642167.
13.	苏清华, 潘小明, 吴宣林. 甲状腺全切除术治疗甲状腺良性疾病 [J]. 中国普外基础与临床杂志, 2004, 11(6): 493495.
14.	刘春萍, 明洁, 石岚, 等. 分化型甲状腺癌手术治疗方法的探讨 [J] . 中国普通外科杂志, 2008, 17(5): 409411.
15.	迟达超, 吴涛, 闫立昆, 等. 分化型甲状腺癌手术方式的探讨 [J]. 陕西医学杂志, 2008, 37(8): 990992.
16.	魏伟, 何向辉, 章志翔. 分化型甲状腺癌的外科治疗 [J]. 中国中西医结合外科杂志, 2010, 16(1): 2224.
17.	陆晔斌, 王志明, 孙维佳, 等. 甲状腺癌487例的手术方式及预后 [J]. 广东医学, 2010, 31(5): 569571.
18.	Amarasinghe IY, Perera NM, Bahinathan N, et al. Review of distribution of nodal disease in differentiated thyroid cancers in an oncosurgical center in Sri Lanka [J]. Ann Surg Oncol, 2007, 14(5): 15601564.
19.	Vaiman M, Nagibin A, Hagag P, et al. Subtotal and near total versus total thyroidectomy for the management of multinodular goiter [J]. World J Surg, 2008, 32(7): 15461551.
20.	杜伟, 刘善廷, 黑虎, 等. 分化型甲状腺癌手术中暴露并保护甲状旁腺的必要性分析 [J]. 中国耳鼻咽喉头颈外科, 2010, 17(9): 449451.
21.	马峻峰, 李燕, 张崇进, 等. 甲状腺癌根治术中喉返神经损伤因素及预防 [J]. 中国医药导报, 2009, 6(5): 1920.
22.	刘永锋. 加强甲状腺疾病的规范化治疗, 提高医生的自我保护 [C]. 沈阳: 中华医学会第四届全国内分泌外科学术会议. 中华医学会第四届全国内分泌外科学术会议论文汇编, 2008: 3136.
23.	孙明举. 4 912例甲状腺病手术并发症分析 [J]. 中国实用外科杂志, 2002, 22（6）: 638641.
24.	Zambudio AR, Rodríguez J, Riquelme J, et al. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery [J]. Ann Surg, 2004, 240(1): 1825.
25.	Kobayashi M, Yuta A, Okamoto K, et al. Nonrecurrent inferior laryngeal nerve with multiple arterial abnormalities [J]. Acta Otolaryngol, 2007, 27(3): 332336.
26.	刘谨文, 沈文状, 张军, 等. 喉返神经的显露在甲状腺癌根治术中的意义 [J]. 临床外科杂志, 2008, 16(6): 384385.
27.	吴毅. 中央区淋巴结清扫术用于分化型甲状腺癌治疗 [J]. 中国实用外科杂志, 2010, 30(10): 898904.
28.	Sultana SZ, Mannan S, Sultana S, et al. Morphological study of parathyroid in relation to thyroid gland of Bangladeshi people [J]. Mymensingh Med J, 2007, 16(2): 137142．.

1. 向俊, 吴毅. 甲状腺癌临床诊治新特点(附572例临床分析) [J]. 中国实用外科杂志, 2008, 28(5): 365367.
2. 郑泽霖, 孙辉, 盖宝东. 甲状腺疾病外科治疗的热点和难点 [J]. 中国普外基础与临床杂志, 2008, 15(5): 307310.
3. 任国胜, 苏新良. 分化型甲状腺癌颈淋巴结清扫术式的选择 [J]. 中国普外基础与临床杂志, 2010, 17(8): 765767.
4. Mitchell I, Livingston EH, Chang AY, et al. Trends in thyroid cancer demographics and surgical therapy in the United States [J]. Surgery, 2007, 142(6): 823828.
5. 徐少明. 对甲状腺癌应慎行甲状腺全切术 [J]. 中国普外基础与临床杂志, 2009, 16(5): 344347.
6. 刘永锋. 加强分化型甲状腺癌的规范化治疗 [J]. 中国普外基础与临床杂志, 2009, 16(5): 341343.
7. Frank R, Vandervelde TL, Doherty GM, et al. Mangement of nodular thyroid disease and thyroid cancer associated with neck irradiation [J]. Probl Ceneral Surg, 2007, 14(6): 2731.
8. Kahky MP, Weber RS. Complications of surgery of the thyroid and parathyroid glands [J]. Surg Clin North Am, 1993, 73(2): 307321.
9. Wagner HE, Seiler C. Recurrent laryngeal nerve palsy after thyroid gland surgery [J]. Br J Surg, 1994, 81(2): 226228.
10. Wheeler MH. The technique of thyroidectomy [J]. J R Soc Med, 1998, 91(Suppl 33): 1216.
11. Fardella C, Jiménez M, González H, et al. Pathological characteristics of thyroid microcarcinoma. A review of 402 biopsies [J]. Rev Med Chil, 2005, 133(11): 13051310.
12. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 19732002 [J]. JAMA, 2006, 295(18): 21642167.
13. 苏清华, 潘小明, 吴宣林. 甲状腺全切除术治疗甲状腺良性疾病 [J]. 中国普外基础与临床杂志, 2004, 11(6): 493495.
14. 刘春萍, 明洁, 石岚, 等. 分化型甲状腺癌手术治疗方法的探讨 [J] . 中国普通外科杂志, 2008, 17(5): 409411.
15. 迟达超, 吴涛, 闫立昆, 等. 分化型甲状腺癌手术方式的探讨 [J]. 陕西医学杂志, 2008, 37(8): 990992.
16. 魏伟, 何向辉, 章志翔. 分化型甲状腺癌的外科治疗 [J]. 中国中西医结合外科杂志, 2010, 16(1): 2224.
17. 陆晔斌, 王志明, 孙维佳, 等. 甲状腺癌487例的手术方式及预后 [J]. 广东医学, 2010, 31(5): 569571.
18. Amarasinghe IY, Perera NM, Bahinathan N, et al. Review of distribution of nodal disease in differentiated thyroid cancers in an oncosurgical center in Sri Lanka [J]. Ann Surg Oncol, 2007, 14(5): 15601564.
19. Vaiman M, Nagibin A, Hagag P, et al. Subtotal and near total versus total thyroidectomy for the management of multinodular goiter [J]. World J Surg, 2008, 32(7): 15461551.
20. 杜伟, 刘善廷, 黑虎, 等. 分化型甲状腺癌手术中暴露并保护甲状旁腺的必要性分析 [J]. 中国耳鼻咽喉头颈外科, 2010, 17(9): 449451.
21. 马峻峰, 李燕, 张崇进, 等. 甲状腺癌根治术中喉返神经损伤因素及预防 [J]. 中国医药导报, 2009, 6(5): 1920.
22. 刘永锋. 加强甲状腺疾病的规范化治疗, 提高医生的自我保护 [C]. 沈阳: 中华医学会第四届全国内分泌外科学术会议. 中华医学会第四届全国内分泌外科学术会议论文汇编, 2008: 3136.
23. 孙明举. 4 912例甲状腺病手术并发症分析 [J]. 中国实用外科杂志, 2002, 22（6）: 638641.
24. Zambudio AR, Rodríguez J, Riquelme J, et al. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery [J]. Ann Surg, 2004, 240(1): 1825.
25. Kobayashi M, Yuta A, Okamoto K, et al. Nonrecurrent inferior laryngeal nerve with multiple arterial abnormalities [J]. Acta Otolaryngol, 2007, 27(3): 332336.
26. 刘谨文, 沈文状, 张军, 等. 喉返神经的显露在甲状腺癌根治术中的意义 [J]. 临床外科杂志, 2008, 16(6): 384385.
27. 吴毅. 中央区淋巴结清扫术用于分化型甲状腺癌治疗 [J]. 中国实用外科杂志, 2010, 30(10): 898904.
28. Sultana SZ, Mannan S, Sultana S, et al. Morphological study of parathyroid in relation to thyroid gland of Bangladeshi people [J]. Mymensingh Med J, 2007, 16(2): 137142．.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Study on Safety of Total Thyroidectomy in Differentiated Thyroid Carcinoma (Report of 72 Cases)

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