KBB-Forum 2019 , Cilt 18, Sayı 4


Seçil BAHAR 1, MD; Günter HAFIZ 1, MD;
1VKV Amerikan Hastanesi, Kulak Burun Boğaz Kliniği, İstanbul, Turkey Objectives: Revision surgeries for recurrent papillary thyroid carcinoma (PTC) are contraversial procedures with limited studies, in small groups of patients. We performed a retrospective study of our revision surgery cases to analyze the results of revision surgeries and the factors affecting the complication rates.

Paitents and Methods: Patients, who have recurrent PTC and underwent revision surgeries from 2008 to 2016 were reviewed. Treatments done before the revision surgeries, demographic data, follow-up period time, recurrence criteria, revision surgery techniques and types, results of the revision surgeries were recorded. Instead of continous monitoring intermittant RLN monitoring used in all our revision surgeries which is first in the literature.

Results: We reviewed 43 patients who underwent revision surgery for recurrent PTC. Eight bilateral central neck dissections and 50 lateral neck dissections were performed as revision surgery. Among 50 lateral neck dissections 23 were operated in previous surgeries. None of the patients developed temporary or permenant vocal cord paralysis (VCP). In one patient temporary hypocalcemia was detected (2.3%). Undetectable thyroglobulin (Tg) levels detected in 29 patients (67.4%) and recurrence did not occur in this group during follow-up period with mean of 7.4 years (range, 3-10 years). In 14 patients (32.6%) with detectable Tg levels, recurrence occurred in 4 patients (28.5%) follow up period with mean of 5.75 years (range, 5-7 years).

Conclusion: Revision surgeries for recurrent PTC have life threatening complications like hypoparathyroidism and VCP. Our results demonstrate close follow-up periods, technologic improvements in nerve monitoring and careful dissection will lower complication rates in this group of patients. Keywords : Papillary; thyroid; cancer; revision