Abstract:
BACKGROUND:Incidence rates of hypoparathyroidism and vocal cord paralysis are high following central compartment reoperation, but few prospective studies have assessed morbidities and factors predictive of hypocalcemia after reoperation. We investigated recurrence patterns, morbidity, and factors predictive of postoperative hypocalcemia in patients undergoing central compartment reoperation for recurrent/persistent differentiated thyroid cancer (DTC). METHODS:We prospectively evaluated 45 consecutive patients with recurrent/persistent DTC. Thyroid remnants or recurrent cancers were removed in 16 patients, the unilateral or bilateral central compartment was cleared in all patients, and the lateral compartment on the diseased side was comprehensively removed from 24 patients. Recurrence patterns were assessed histopathologically, morbidities were monitored, and serum concentrations of calcium and intact parathyroid hormone (iPTH) were measured in all patients. RESULTS:Eleven patients (24.4%) had tumor invasion into the recurrent laryngeal nerve and/or the tracheoesophagus. Central nodal involvement occurred frequently (86.7%), and the ipsilateral jugular nodes of the lateral compartment were frequently involved. Temporary and permanent vocal cord paralysis developed in 10 (22.2%) and 8 (17.8%) patients, respectively, due primarily to intentional nerve resection following tumor invasion. Of 41 patients without preoperative hypoparathyroidism, 21 (46.3%) had temporary and 2 (4.9%) had permanent hypocalcemia. Multivariate analysis showed that bilateral central compartment dissection and low iPTH levels (<12.0 pg/ml) were independent predictors of postoperative hypocalcemia. CONCLUSIONS:Most patients with recurrent/persistent DTC harbor lesions in the central compartment. Central compartment reoperation may lead to high rates of morbidity, including hypoparathyroidism, which can be predicted by surgical extent and low serum iPTH levels.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Roh JL,Kim JM,Park CIdoi
10.1245/s10434-010-1470-9subject
Has Abstractpub_date
2011-05-01 00:00:00pages
1312-8issue
5eissn
1068-9265issn
1534-4681journal_volume
18pub_type
杂志文章abstract:BACKGROUND:The association between procedure volume and clinical outcomes has led many to advocate centralization of cancer procedures at high-volume centers (HVCs). Regional studies show practice patterns changing with increasing centralization of esophageal and pancreatic procedures at HVCs but little change for colo...
journal_title:Annals of surgical oncology
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doi:10.1245/s10434-010-1159-0
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abstract:BACKGROUND:Breast reconstruction following mastectomy has been shown to have a salutary effect on the overall psychological well-being of women being treated for breast cancer. Unfortunately, however, not every patient is an ideal candidate for reconstruction. Complications stemming from reconstructive surgery can caus...
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journal_title:Annals of surgical oncology
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doi:10.1245/s10434-008-0061-5
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更新日期:2014-05-01 00:00:00
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更新日期:2019-03-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2003-11-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
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更新日期:2009-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02305535
更新日期:1997-10-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2014-06-01 00:00:00
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journal_title:Annals of surgical oncology
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更新日期:2011-03-01 00:00:00
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journal_title:Annals of surgical oncology
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