Lesreinterventions tardives apres thyroidectomie pour lesion benigne

ABSTRACT

From january 1974 to decembre 1988, 1252 thyroidectomies were caried out including 33 cases who are twice surgically managed for recurrence, 2,6% Of the 33 patients, 18 [544% did not undergo primitive surgery in the service. Recurrence results from two main diseases multiheteronodular goiter [4,85%] and Basedow's disease [4,30%] Among the methods that were used, enucleation is the most implicated [33%]; subtotal lobectomy ranks second with 7,62%. Recurrence is often Contralateral reproducing the primary disease in most cases; however it is neoplasic in one case [3%]. This latter eventuality justifies the surgical remanagement whose main preoccupations must be, as far as possible, preservation of thyroidal function and respect of reccurrents and parathyroids The treatment must be essentially preventive since that the rate of complications and sequelae is higher than in the usual surgery. Prevention is more particularly based on surgery during the first management. As for opotherapy, its braking is still a controversial question