An Evaluation of the Factors Affecting Failure of the Procedure in reoperated Thyroidectomies: A Retrospective Analysis

Comcali B., Ozdemir B. A., Atas H., ÖZDEMİR E., Tikici D., Saylam B.

AMERICAN SURGEON, cilt.88, sa.8, ss.2039-2044, 2022 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 88 Sayı: 8
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1177/00031348211023426
  • Dergi Adı: AMERICAN SURGEON
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Agricultural & Environmental Science Database, CAB Abstracts, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.2039-2044
  • Anahtar Kelimeler: Revison surgery, surgical failure, intraoperative neuromonitorisation, RECURRENT LARYNGEAL NERVE, SURGERY
  • İnönü Üniversitesi Adresli: Evet

Özet

Background The aim of this study was to determine the factors affecting procedure failure in revision thyroidectomy surgery. Methods A total of 148 patients applied with revision surgery were separated into 2 groups according to the surgical success status. Comparisons were made of the 2 groups of patients where residual tissue was totally excised (Group 1, n:132) and patients where residual tissue could not be completely excised (Group 2, n:16). The patients were examined in respect of factors affecting the success of the procedure. Results The patients comprised 133 (89.9%) females and 15 (10.1%) males with a mean age of 49.68 +/- 12.02 years. Surgical failure was observed in 7 patients as the lesion could not be determined despite the use of intraoperative USG, and in 9 patients because of weak signal or signal loss. The determination of residual tissue <= 25mm on preoperative USG examination was seen to have a significant negative effect on surgical success (r=-0.329, p0.001). The patient having undergone >= 3 previous operations was determined to have a negative effect on surgical success (r=-0.229, p=0.005), and nerve damage on the opposite side to the lesion in a previous surgical procedure was determined to be the most important factor with a negative effect on surgical success (r=-0.571, p<0.001). In multinomial logistic regression analysis of the factors affecting success, the preoperative presence of nerve damage in the contralateral lobe to the lesion (OR: 33.11, 95% CI: 4.22-192.28, p<0.001) and lesion size <= 25 mm (OR: 10.10, 95% CI: 3.54-75.01, p=0.001) were determined to contribute significantly to surgical failure. Conclusion The results of this study clearly showed that as residual tissue size <= 25mm and contralateral nerve damage in the preoperative ultrasonographic evaluation are associated with surgical failure, alternative treatment methods such as radioactive iodine ablation may be preferred in these patients.