갑상선암으로 갑상선 전절제술 및 경부 림프절 절제술 후 합병증

• 영문명: Complication after Total Thyroidectomy and Node Dissection for Thyroid Cancer
• 발행기관: 대한내분비외과학회
• 저자명: 노수영 고병균 김연선 Soo Young Noh M.D. Byung Kyun Ko M.D. and Yon Seon Kim M.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』11권3호, 169~174쪽, 전체 6쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2011.09.30

영문 초록

Purpose: The typical complications after thyroidectomy are bleeding, hematoma, hoarseness, hypocalcemia, chylous fistula, etc. The aim of this study was to determine the incidence and to evaluate risk factors of complication after total thyroidectomy and lymph node dissection (ND) for thyroid cancer. Methods: We performed a retrospective review of 623 patients with thyroid cancer and who underwent total thyroidectomy and ND and the patients were treated at our hospital from March 2007 to February 2010. The clinical features of complications were reviewed and the incidence and predisposing factors of the complication were analyzed. Results: Postoperative bleeding occurred in 0.2% of the patients. The overall incidence of transient and permanent hypocalcemia was 8.5% and 0.6%, respectively. Graves disease, a decreased number of preserved parathyroid glands and an increased number of removed central lymph nodes constituted the risk factors for postoperative hypocalcemia. On multivariate logistic regression analysis, the presence of Graves disease and a decreased number of preserved parathyroid glands were the independent risk factors for postoperative hypocalcemia. Hoarseness occurred in 1.6% of the patients. The incidence of chylous fistula after lymph node dissection in the central neck and lateral neck was 0.5% and 0.3%, respectively. Conclusion: Total thyroidectomy with ND is a safe procedure because the overall incidence of postoperative complications is low. Careful surgery is required for thyroid cancer patients with Graves disease. Parathyroid gland insufficiency is the important cause of hypocalcemia after total thyroidectomy and ND. To reduce voice change, careful dissection is required around the recurrent laryngeal nerve and excessive tracheal traction should be avoided. (Korean J Endocrine Surg 2011;11:169-174)

키워드

갑상선암, 갑상선 전절제술, 합병증,Thyroid cancer, Total thyroidectomy, Complication