[Results of reoperations for goiter]

Abstract

We report 47 reoperations for benign thyroid goiters between February 1994 and October 1995 out of a total of 1125 thyroidectomies. These operations concerned 42 women and 5 men with an average age of 54 years. The mean time between the 2 operations was 19 years. On 45 occasions, the reoperation included a totalisation of the previous partial thyroidectomy. In 2 cases a near total thyroidectomy was performed leaving a minimal thyroid remnent on one side. The mean weight of the resected gland was 73 grs. The morbidity included 2 temporary recurrent laryngeal nerve palsies resolving within 2 months and 7 cases of temporary hypocalcemia without permanent hypocalcemia. In the case of repeated surgery, the risks of recurrent laryngeal nerve damage and parathyroid gland resection are typically increased. The risk varies according to the initial surgical resection: unilateral lobectomy versus bilateral subtotal lobectomy. Surgical risks can be significantly decreased with a safe surgical technique. Indications for reoperations in case of benign thyroid goiter are rare and can probably still be reduced. Treatment with thyroxin is sometimes ineffective and is questionable after sub total thyroidectomy for nodular goiter. A primary total thyroidectomy can be indicated in such selected cases.