ABSTRACT
A series of 640-operations performed on benign thyroid gland during 8 years is presented. The pre and post operative mortality is 0.62 per cent. Late recurrent nerve paralysis occurred in 2.6 per cent. 27 patients had transit hypocalcemia and 8 had permanent hypoparathyroidism or 1.2 per cent. These complications has been studied in relation with patient benign thyroid affection and operation. In case of thyroidectomy without search for recurrent laryngeal nerve, nervous paralysis are frequent when if parathyroid gland are rare, for these lata are protected. Systematic dissection of recurrent nerve reduce nervous sequelae, but increase hypoparathyroidism, mainly by devascularisation of parathyroids glands. Complications and sequelae of thyroid surgery can yet be reduced by a rigorous surgical technic, a most sure experience and a systematic dissection of recurrent nerve and gland parathyroid in case of bilateral operation.
Subject(s)
Thyroid Diseases/surgery , Thyroidectomy/adverse effects , Female , Hemorrhage/etiology , Humans , Hypocalcemia/etiology , Male , Paralysis/etiology , Postoperative Period , Recurrent Laryngeal Nerve Injuries , Thyroid Crisis/etiology , Thyroidectomy/methods , Thyroidectomy/mortalityABSTRACT
From 1981 to 1987, 305 patients underwent surgery in this department for thyroid disorders, including 7 reinterventions for total thyroidectomy, with a mortality of 0.75% and a specific morbidity of 13.4%. The overall incidence of post-operative parathyroid insufficiency was 4.6%. This was higher after bilateral thyroidectomy (7.6%) than after unilateral thyroidectomy (0.7%). The early parathyroid risk was also higher after surgery for hyperthyroidism (9.7%) than after surgery for euthyroid goitres (2.4%). The true incidence of post-operative parathyroid insufficiency can only be evaluated by systematic clinical and biological investigation. Parathyroid insufficiency is due to devascularisation of one or several parathyroids during the course of thyroidectomy, or occasionally due to accidental resection with the thyroid lobe. The prevention of post-operative parathyroid insufficiency requires a surgical technique which limits any devascularisation of the parathyroid glands and if the vascular supply to a parathyroid is put at risk then autotransplantation should be performed.
Subject(s)
Hypoparathyroidism/etiology , Thyroidectomy/adverse effects , Adolescent , Adult , Aged , Female , Humans , Hypocalcemia/etiology , Male , Middle Aged , Parathyroid Glands/anatomy & histology , Parathyroid Glands/blood supply , Retrospective Studies , Risk Factors , Thyroidectomy/methodsABSTRACT
Results are reported of treatment of multiple hydatid cysts of liver in 19 patients (63 cysts) between 1981 and 1985. The relative frequency and severity of forms of multiple localization are emphasized as well as particular features related to extra-hepatic abdominal localizations. Diagnosis is assisted by ultrasound and particularly CT scan imaging in multiple forms. Since surgical excision remains the only potentially curative treatment for hydatid cyst, conservative therapy by puncture-sterilization and aspiration, with or without combined medical treatment, can be proposed when certain localizations make conventional surgery difficult and dangerous for vital prognosis.
Subject(s)
Echinococcosis, Hepatic/therapy , Adolescent , Adult , Biopsy, Needle , Child , Echinococcosis, Hepatic/diagnosis , Echinococcosis, Hepatic/pathology , Echinococcosis, Hepatic/surgery , Female , Humans , Male , Middle Aged , Prognosis , Tomography, X-Ray Computed , UltrasonographyABSTRACT
Could the association of common duct stones and agenesis of the gallbladder be a coincidence or are they related to a cause and effect phenomenon? After having dealt with different physiopathological hypothesis, the authors think that common duct stones result from that congenital absence of the gallbladder. A method to ascertain their hypothesis is put forward.
