title: [Repeated thyroid surgery. Indications and results].
abstract: OBJECTIVE
  To analyze the histology results and to assess operative risk of iterative operations for thyroid surgery.
  
  
  METHODS
  A total of 249 re-operations were performed in 248 patients over a 6.5 year period. Two groups of patients were defined according to the indications for re-operation. Group 1: 80 patients; pathology examination of the surgical specimen discovered thyroid cancer. Group 2: 169 patients; recurrent nodular goitre after an initially benign disease.
  
  
  RESULTS
  In group 1, 14 cancers were bilateral (17.5%) and 7 patients had cervical node metastases (8.8%). In group 2, 19 cancers were discovered (11.1%), including 5 cases with cervical node invasion (26.3%) and 4 with visceral metastases (21.1%). Twenty complications occurred in 20 patients (8%): compressive cervical hematomas (n = 3, 1.2%), recurrent nerve palsy (n = 7, 2.8%), hypoparathyroidism (n = 9, 3.6%; including 3 definitive cases, 1.2%) and mediastinitis (n = 1). These complications were significantly more frequent in patients re-operated for hyperthyroidism or those who had a past history of more than one cervicotomy.
  
  
  CONCLUSIONS
  The frequency of bilateral cancer justifies completing thyroidectomy after partial thyroidectomy. The rate of definitive complications after re-operations is greater than first line cervicotomy but is low enough to allow iterative surgery using rigorous procedure in selected patients.
authors.affiliation: Service de Chirurgie générale et digestive, Hôpital de la Pitié, Paris.
authors.forename: F
authors.initials: F
authors.lastname: Menegaux
authors.forename: L
authors.initials: L
authors.lastname: Leenhardt
authors.forename: M
authors.initials: M
authors.lastname: Dahman
authors.forename: G
authors.initials: G
authors.lastname: Schmitt
authors.forename: A
authors.initials: A
authors.lastname: Aurengo
authors.forename: J P
authors.initials: JP
authors.lastname: Chigot
mesh_terms: D006044:Goiter, Nodular / Q000473:pathology / Q000601:surgery*; D006801:Humans; D012086:Reoperation; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy