caa a22 4500 47703652X CHVBK 20180405111306.0 cr unu---uuuuu 170330e19960601xx s 000 0 eng 10.1007/s002689900092 doi (NATIONALLICENCE)springer-10.1007/s002689900092 Thyroid Gland Surgery in an Endemic Region [Elektronische Daten] [Christian Seiler, Christine Glaser, Hans Wagner] To assess the incidence, indications, and complications of (reoperative) thyroid gland surgery in an endemic region, we have retrospectively analyzed 1318 patients operated on between 1983 and 1994. There were 166 reoperations (13.5%). In comparison to the primary operation the indication for reoperation showed an increased rate of premalignant and malignant tumors (+16%) and a decreased rate of hyperthyroid disorders (−30%). The largest group operated on had benign multinodular goiters, with the same rate of indication for primary (57.4%) and secondary (57.8%) surgery. Permanent recurrent laryngeal nerve palsy rate following primary operation occurred at rates of 1.7% (1983-1990) and 0.7% (1991-1994) and for secondary operation 3.5% (1983-1990) and 5.6% (1991-1994), respectively. The change in recurrent nerve palsy rate in the later years was due to a more extensive resection policy at the primary operation and a more liberal approach to reoperative surgery. The high rate of reoperation for benign goiters (13%) and the new data of goitrogenesis have therefore directed our policy to more extensive resection of the thyroid tissue at the initial operation, increasing the rate of lobectomy from 27% (1982-1990) to > 90% (1991-1994) and at the same time lowering morbidity. Extensive resection of nodular tissue during the initial operation safely reduces the incidence of recurrent goiter and subsequently reduces the rate of reoperation and eliminates the high risk of morbidity associated with reoperative thyroid surgery. The indications for reoperation should be strict, and when unavoidable a modified lateral approach may be helpful. Société Internationale de Chirugie, 1996 Seiler Christian Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010, Bern, Switzerland aut Glaser Christine Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010, Bern, Switzerland aut Wagner Hans Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010, Bern, Switzerland aut World Journal of Surgery Springer-Verlag 20/5(1996-06-01), 593-597 0364-2313 20:5<593 1996 20 268 https://doi.org/10.1007/s002689900092 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900092 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Seiler Christian Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Glaser Christine Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Wagner Hans Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010, Bern, Switzerland aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 20/5(1996-06-01), 593-597 0364-2313 20:5<593 1996 20 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer