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完成甲状腺手术是否会增加并发症的风险?
Alaa Sada1, Kimberly M Ramonell1, Kelly L McCoy1
1Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
World journal of surgery
|March 14, 2025
概括
完成甲状腺切除术 (CT) 显示了与甲状腺叶切除术 (TL) 相似的并发症率. 与CT相比,全甲状腺切除术 (TT) 具有较高的临时和长期甲状腺缺血症风险.
科学领域:
- 内分泌手术 内分泌手术
- 外科手术的结果
- 甲状腺癌管理与管理
背景情况:
- 完成甲状腺切除术 (CT) 的结果没有得到充分的记录.
- 将CT风险与全甲状腺切除术 (TT) 和甲状腺叶切除术 (TL) 的风险进行比较,对于患者的护理至关重要.
- 一个大型的多机构数据库被用来评估这些风险.
研究的目的:
- 为了比较全甲状腺切除术 (TT),甲状腺叶切除术 (TL) 和完成甲状腺切除术 (CT) 的并发症风险.
- 评估不同类型甲状腺切除术的短期和长期结果.
- 为了确定CT是否比TL带来更高的风险.
主要方法:
- 利用CESQIP国家数据库 (2013-2023) 针对没有淋巴切除术的甲状腺切除术病例.
- 定义CT作为对侧叶切除术后的初始叶切除术.
- 检查的结果包括血瘤,声带功能障碍和副副甲状腺功能障碍.
主要成果:
- 血液瘤发生率在TT (0.8%),TL (0.5%) 和CT (<0.7%) 中很低.
- 声带功能障碍的发生率与TT (1.4%),TL (1.3%) 和CT (1.0%) 类似.
- 临时性甲状腺功能低下症在TT (6%) 后比CT (2%) 更常见;长期的甲状腺功能低下症在TT (2.5%) 和CT (0.7%) 后也更高.
结论:
- 完成甲状腺切除术 (CT) 与甲状腺叶切除术 (TL) 的长期并发症率相当.
- 与CT相比,全甲状腺切除术 (TT) 与暂时性和长期性甲状腺缺血症的发生率显著增加.
- CT似乎没有比TL更高的并发症风险.
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