갑상선 전절제술 및 아전절제술에 대한 임상적 고찰

Abstract

We got following results by analyzing 36 cases of subtotal thyroidectomies and 26 cases of total thyroidectomies for thyroid cancers which were operated at the Department of General Surgery in Seoul National University Hospital for recent 2 years. 1. The frequency of In\llticentricity was 16% (in 8 of 51 cases) papillary ca., however, there was no case of multicentricity in follicular ca. (of 6 cases) and medullary ca. (of 1 case). But we can not conelude because of scanty samples in this case. 2. There was little difference in the frequency of postoperative hoarseness due to injury of recurrent laryngeal nerves between subtotal and total thyroid" ectomy (each 3% and 4%). 3. The frequency of permanent hypocalcemia due to injury of parathyroid glands was higher in total thyroidectomies than in subtotal thyroidectomies(each 996 and 0%). 4. A group which had reoperation because of recurrence after the first minor procedure has higher incidence of permanent hoarseness and hypocalcemia than a group which had thyroidectomy once (hoarse ness: each 4% and 22%; hypocalcemia: each 4% and 22%). Most of thyroid cancers were papillary ca. (80%), and multicentricity of it was high. The incidence of postoperative complications of reoperation because of recurrence after minor procedure (simple lobectomy) was higher than that of the first operation. This result suggests that more extensive procedures(subtotal or total thyroidectomy) are more desirable than the minor procedures in the treatment of thyroid cancer. We are going to support this conclusion by longterm comparative follow-up studies of recurrence rates and survival rates between minor procedure group and more extensive procedure- group.