Özet:

Purpose: Secondary thyroid surgery is rarely applied to primary surgery. It is known that the risk of complications in secondary surgeons is high due to the increased fragility of the narrow tissue and tissue that is caused by the delay in surgery. A lot of surgery technique and strategy is repaid to reduce the rate of complications in secondary surgeons. In this calisma, we aimed at reducing the rates of complications in cases of secondary thyroid surgery using intraoperative nerve monitoring (IONM) with lateral approach. More once the cause of benign and malignant thyroid diseases is a thyroid surgery delayed and secondary surgical injection applied by 44 hospitals (Group 1), primary surgical applied by the last 44 hospitals (Group 2) data. After lobectomy was done, malignity in the pathology was detected and the patients who were applied to diger lobba supplementary thyroidectomy were caused by calisma. In secondary surgery, sternokleidomastoid muscle was applied by lateral approach by entering between the ten edges and strep muscles. In the primary surgery, the thyroid lotion was entered from the middle line. IONM standard is applied to tum patients. Regardless of whether hypocalcemia is a clinical symptom or not, the serum calcium dose was identified as a decrease of 8 mg/dl or below in the first 48 hours. The transitional and qualitative recurrent laryngeal nerve paralysis was degraded to the nerve number at risk. Loba applied intramuscular; Nuks, Graves disease, substernal guatr, central disection applied is defined as intramuscular risk intramuscular. Results: The Yas average was 49,9+14,1 and 45+12,6 (22-90) with sirasi in groups 1 and 2 (p=0,69). The gender rate in groups 1 and 2 was the female ratio of 90.9% (n: 40), 75% (n: 33) (p=0.87). In Group 1 and 2, 11 (% 25) and 7 (% 15.9) patients with malignant cause of the disease (p=0.29) were administered. Two-sided injection was applied to patients in group 1 and 2 with sirasi 26 (59.1%) and 28 (63.6%). Transitional and calcium hypokalcemic rates in groups 1 and 2 were 34.1 percent (n: 15), 22.5 percent, 2.5 percent (n: 1), 0 percent, and the difference was not meaningful (p=0.237, p=1). In the first group, 71 in the second group, 72 lobes were localized. All entries in Group 1 (100%) and 23 entries in Group 2 (31.9) were high-risk entries, and the difference between them was significant (p<0,0001). In Group 1 and 2, the ratio of passive vocal cord paralysis was 4.2 % (n: 3), 6.9 % (n: 5) (p=0.719), while the ratio of qualitative vocal cord paralysis was 2.8 % (n: 2) and 0 % (p=0.245). Results: Secondary surgical inputs can be applied with careful and rigorous surgical technique without increasing the rate of qualitative complications in the primary inputs. The tum inputs may be related to the use of IONM alongside the primary inputs, the rate of vocal cord paralysis may not be similar to the primary inputs and the use of IONM alongside the technin.

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