Redo in Thyroid Surgeries

Abstract

Background: Revision of thyroid surgery is usually technically difficult because of anatomical changes and subsequent fibrosis after the primary surgery especially in the central neck. However, with experience and appropriate preparation, the risk of permanent hypoparathyroidism or recurrent laryngeal nerve injury after revision surgery is reduced.

Objective: The aim of the study was to determine the causes of redo in thyroid surgeries, operative difficulties and postoperative complications.

Patients and Methods: This prospective randomized controlled study included a total of 60 patients with primary total thyroidectomy and redo surgery, attending at Endocrine Surgery Unit, General Surgery Department, and Mansoura University Hospitals. This study was conducted between February 2018 and January 2019. The included subjects were randomly divided into three main groups: Group 1 (primary total thyroidectomy) consisted of 20 patients underwent total thyroidectomy, Group 2 (early redo surgery) consisted of 20 patients underwent completion thyroidectomy, and Group 3 (late redo surgery) consisted of 20 patients underwent recurrent thyroidectomy.

Results: Compared to total thyroidectomy, early and late redo in thyroid surgeries gave better results regarding the recurrence and complications, which occurred in no one case 1 year later.

Conclusion: From this study it is shown that total thyroidectomy is advised to be done in all patients with thyroid diseases as there were no recurrence detected and to avoid complications that may be present in redo surgery. To guard against performance of completion thyroidectomy, ultrasound examination and fine needle aspiration cytology (FNAC) should be taken from different sites.