[Surgical reinterventions in neck after elective procedures]

Our objective was to determine the frequency of surgical reinterventions for recurrence or disease persistence after elective surgical procedures of the neck.

We used a transversal and comparative study, accomplished during a 6-year period. Emergency initial surgical procedures were excluded. The patients were divided according to the type of hospital where the initial surgical procedure was performed--those treated at a specialized medical center and those operated on in general hospitals. The variables evaluated were preoperative and pathological diagnosis, previous surgical procedures, and the time between the primary surgery and the definitive procedure.

Three hundred sixty-two cases were included. Of these, 27 patients (7.45%) required surgical reinterventions. Time elapsed between the first and the definitive procedure was 1 to 19 years. Diagnostic concordance between the initial and final diagnosis was 89%. According to the type of hospital where the initial procedure was performed (specialized vs. general hospitals), we observed the following reintervention frequencies: parathyroid, 12.2% vs. 12.2% (p = 0.6); thyroid, 1.63% vs. 5.88% (p <0.05); thyroglossal duct cyst, 1.65% vs. 5.83% (p = 0.41), respectively.

The specialized hospital admits patients with multiple problems, poor response, or inadequate therapeutic indication. For thyroid pathologies the odds ratio established a probability of 6.8 for major reintervention in those patients treated in non-specialized hospitals.