Reoperative surgery for thyroid disease

Lefèvre, Jérémie H.; Trésallet, Christophe; Leenhardt, Laurence; Jublanc, C.; Chigot, Jean-Paul; Ménégaux, Fabrice

doi:10.1007/s00423-007-0201-6

Cited by 160 publications

(125 citation statements)

References 13 publications

(12 reference statements)

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“…The risk varies according to the initial surgical resection: unilateral lobectomy versus bilateral subtotal lobectomy (16) . A higher risk of complications is described when previous surgery has been performed on both sides (10) . The risk of complications increased with the number of reoperations (7) .…”

Section: Discussionmentioning

confidence: 99%

“…Reoperative thyroid surgery had more frequent recurrent laryngeal nerve injuries, both temporary (0-22%) and permanent (0-13%) (7,20) . Hyperthyroidism and not exposing the nerve during operation were predisposing factors (10,19) . In our experience transient recurrent laryngeal nerve palsy was five times higher than for primary operations and difference was highly significant.…”

Section: Discussionmentioning

confidence: 99%

“…We had no mortality in our experience. In repeat surgery for recurrences the lateral approach is popular as it avoids the infiltration by connective tissue of Kocher's approach (7,10,22) and allows identification of the nerves in a previously un-dissected area (23) . Rather than reopening the median raphe, the straps are retracted medially and a plane anterior to the sternocleidomastoid muscle is entered (7) .…”

Section: Discussionmentioning

confidence: 99%

“…Suppression of TSH L-thyroxin therapy can be used to prevent the recurrence and is useful only in 30 % of patients (1,(4)(5)(6)(7)(8)(9) . Reoperative thyroid surgery is indicated in case of recurrent unilateral or multi nodular goiter, when it is associated with compression or in case of suspected malignancy, and in recurrent thyrotoxicosis (7,10) . The scar tissue from previous surgery make recurrent laryngeal nerve and vascular pedicle of the parathyroid vulnerable for injury (11) .…”

Section: Introductionmentioning

confidence: 99%

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Reoperative Thyroid Surgery - Our Experience

Hussain¹

2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reoperative Thyroid Surgery - Our Experience

Hussain¹

2016

jmscr

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“…Treatment in these patients can involve reoperation and/or radioactive iodine-131 therapy. However, reoperation is associated with significantly increased morbidity, particularly with a 1.5% chance of recurrent laryngeal nerve palsy and a 2.5% chance of hypoparathyroidism (4). Postoperative scarring can make reoperation difficult, secondary to unclear anatomy, leading to longer operative times and morbidity (5,6).…”

Section: Surveillance For Recurrence Can Include Measuringmentioning

confidence: 99%

Operative bed recurrence of thyroid cancer: utility of a preoperative needle localization technique

et al. 2016

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Background: Surgical management of recurrent disease after total thyroidectomy and/or neck dissection for thyroid carcinoma remains a challenging clinical problem. Reoperation is associated with a significant increase in morbidity. Preoperative needle localization technique for non-palpable breast tumors has recently been extrapolated to head and neck surgery. We report on the use of preoperative ultrasound-guided needle localization for non-palpable recurrent operative bed disease as an intraoperative aid in resection.Methods: Patients with thyroid carcinoma were identified from a retrospective database at a tertiary care center from 2011-2014. Inclusion criteria were history of thyroidectomy and/or neck dissection, nonpalpable recurrent disease in the resection bed on surveillance, and ultrasound-guided needle localization of recurrent disease before resection. Perioperative data and outcomes were analyzed.Results: Seventeen patients were identified using the inclusion criteria listed above. Median patient age was 46 years (53% male, 47% female). A total of 23 masses in the previous operative bed were needlelocalized successfully with no major long-term sequelae from this technique. The recurrent laryngeal nerve was involved with tumor in six patients. Two patients, in whom the tumor surrounded the nerve circumferentially, experienced recurrent laryngeal nerve injuries. No patients experienced postoperative hypocalcemia. With a routine surveillance and a median follow-up of 558 days, sixteen of the patients remain with no evidence of disease.Conclusions: Preoperative ultrasound-guided needle localization of non-palpable recurrent operative bed disease after thyroidectomy and/or neck dissection is a potentially safe method to aid in resection and cure.

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