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, 吳毅. 甲狀腺癌臨床診治新特點(附572例臨床分析) [J]. 中國實用外科雜志, 2008, 28(5): 365367.
2.	鄭澤霖, 孫輝, 蓋寶東. 甲狀腺疾病外科治療的熱點和難點 [J]. 中國普外基礎與臨床雜志, 2008, 15(5): 307310.
3.	任國勝, 蘇新良. 分化型甲狀腺癌頸淋巴結清掃術式的選擇 [J]. 中國普外基礎與臨床雜志, 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. 對甲狀腺癌應慎行甲狀腺全切術 [J]. 中國普外基礎與臨床雜志, 2009, 16(5): 344347.
6.	劉永鋒. 加強分化型甲狀腺癌的規范化治療 [J]. 中國普外基礎與臨床雜志, 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.	蘇清華, 潘小明, 吳宣林. 甲狀腺全切除術治療甲狀腺良性疾病 [J]. 中國普外基礎與臨床雜志, 2004, 11(6): 493495.
14.	劉春萍, 明潔, 石嵐, 等. 分化型甲狀腺癌手術治療方法的探討 [J] . 中國普通外科雜志, 2008, 17(5): 409411.
15.	遲達超, 吳濤, 閆立昆, 等. 分化型甲狀腺癌手術方式的探討 [J]. 陜西醫學雜志, 2008, 37(8): 990992.
16.	魏偉, 何向輝, 章志翔. 分化型甲狀腺癌的外科治療 [J]. 中國中西醫結合外科雜志, 2010, 16(1): 2224.
17.	陸曄斌, 王志明, 孫維佳, 等. 甲狀腺癌487例的手術方式及預后 [J]. 廣東醫學, 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.	杜偉, 劉善廷, 黑虎, 等. 分化型甲狀腺癌手術中暴露并保護甲狀旁腺的必要性分析 [J]. 中國耳鼻咽喉頭頸外科, 2010, 17(9): 449451.
21.	馬峻峰, 李燕, 張崇進, 等. 甲狀腺癌根治術中喉返神經損傷因素及預防 [J]. 中國醫藥導報, 2009, 6(5): 1920.
22.	劉永鋒. 加強甲狀腺疾病的規范化治療, 提高醫生的自我保護 [C]. 沈陽: 中華醫學會第四屆全國內分泌外科學術會議. 中華醫學會第四屆全國內分泌外科學術會議論文匯編, 2008: 3136.
23.	孫明舉. 4 912例甲狀腺病手術并發癥分析 [J]. 中國實用外科雜志, 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.	劉謹文, 沈文狀, 張軍, 等. 喉返神經的顯露在甲狀腺癌根治術中的意義 [J]. 臨床外科雜志, 2008, 16(6): 384385.
27.	吳毅. 中央區淋巴結清掃術用于分化型甲狀腺癌治療 [J]. 中國實用外科雜志, 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, 吳毅. 甲狀腺癌臨床診治新特點(附572例臨床分析) [J]. 中國實用外科雜志, 2008, 28(5): 365367.
2. 鄭澤霖, 孫輝, 蓋寶東. 甲狀腺疾病外科治療的熱點和難點 [J]. 中國普外基礎與臨床雜志, 2008, 15(5): 307310.
3. 任國勝, 蘇新良. 分化型甲狀腺癌頸淋巴結清掃術式的選擇 [J]. 中國普外基礎與臨床雜志, 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. 對甲狀腺癌應慎行甲狀腺全切術 [J]. 中國普外基礎與臨床雜志, 2009, 16(5): 344347.
6. 劉永鋒. 加強分化型甲狀腺癌的規范化治療 [J]. 中國普外基礎與臨床雜志, 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. 蘇清華, 潘小明, 吳宣林. 甲狀腺全切除術治療甲狀腺良性疾病 [J]. 中國普外基礎與臨床雜志, 2004, 11(6): 493495.
14. 劉春萍, 明潔, 石嵐, 等. 分化型甲狀腺癌手術治療方法的探討 [J] . 中國普通外科雜志, 2008, 17(5): 409411.
15. 遲達超, 吳濤, 閆立昆, 等. 分化型甲狀腺癌手術方式的探討 [J]. 陜西醫學雜志, 2008, 37(8): 990992.
16. 魏偉, 何向輝, 章志翔. 分化型甲狀腺癌的外科治療 [J]. 中國中西醫結合外科雜志, 2010, 16(1): 2224.
17. 陸曄斌, 王志明, 孫維佳, 等. 甲狀腺癌487例的手術方式及預后 [J]. 廣東醫學, 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. 杜偉, 劉善廷, 黑虎, 等. 分化型甲狀腺癌手術中暴露并保護甲狀旁腺的必要性分析 [J]. 中國耳鼻咽喉頭頸外科, 2010, 17(9): 449451.
21. 馬峻峰, 李燕, 張崇進, 等. 甲狀腺癌根治術中喉返神經損傷因素及預防 [J]. 中國醫藥導報, 2009, 6(5): 1920.
22. 劉永鋒. 加強甲狀腺疾病的規范化治療, 提高醫生的自我保護 [C]. 沈陽: 中華醫學會第四屆全國內分泌外科學術會議. 中華醫學會第四屆全國內分泌外科學術會議論文匯編, 2008: 3136.
23. 孫明舉. 4 912例甲狀腺病手術并發癥分析 [J]. 中國實用外科雜志, 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. 劉謹文, 沈文狀, 張軍, 等. 喉返神經的顯露在甲狀腺癌根治術中的意義 [J]. 臨床外科雜志, 2008, 16(6): 384385.
27. 吳毅. 中央區淋巴結清掃術用于分化型甲狀腺癌治療 [J]. 中國實用外科雜志, 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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