Morbidity rate of reoperation in thyroid surgery: a different point of view.
BACKGROUND
Goitre recurrence is a common problem following subtotal thyroid gland resection for multinodular goitre disease. The aim of the present study was to evaluate morbidity rate in relation to the side of initial and redo-surgery for recurrent disease.


METHODS
A total of 1699 patients underwent consecutive thyroid gland surgery between 1997 and 2010 at our institution. One hundred and eighteen patients (6.9%) underwent redo-surgery for recurrent disease after subtotal resection. One hundred and nine patients with complete follow-up were included in the present study.


RESULTS
Recurrent disease was found in 79 patients (72.5%) in the ipsilateral lobe and in 30 patients (27.5%) in the contralateral lobe. The incidence of permanent recurrent laryngeal nerve palsy was significantly higher in patients undergoing redo-surgery on the ipsilateral lobe compared to patients undergoing initial operation (3.8% vs. 1.1%; p = 0.03), whereas no difference was found in patients with contralateral redo-surgery compared to patients undergoing initial operation (p = 1.0). Independent risk factors for contralateral recurrent disease were age at primary operation <37 years (OR 4.86; 95% CI 1.58-15.01) and time to recurrence <20 years (OR 6.53; 95% CI 2.23-19.01).


CONCLUSIONS
Morbidity rate for recurrent disease after subtotal resection was significantly higher for ipsilateral redo-surgery compared to initial surgery, whereas redo-surgery can be performed safely on the contralateral lobe. Young age at primary operation and short time to recurrence are independent risk factors for contralateral recurrent disease.
Department of Visceral Surgery and Medicine Inselspital University Hospital Bern University of Bern, Switzerland. anita.kurmann@insel.ch
Anita
A
Kurmann
Uta
U
Herden
Stefan W
SW
Schmid
Daniel
D
Candinas
Christian A
CA
Seiler
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006042:Goiter / Q000601:surgery*; D006801:Humans; D061224:Laryngeal Nerve Injuries / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation / Q000009:adverse effects; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D013997:Time Factors; D055815:Young Adult