| Summary: | From 1996 to 2001, 393 thyroidectomies were performed and 25 (6.4%) patients underwent reoperative thyroid surgery at Hospital Universiti Sains Malaysia. All reoperated patients had undergone one prior thyroid operation. All were females with an average age of 39.1 years (18-61 years). The most frequent indication for reoperation was cancer in resected specimen of an originally misdiagnosed carcinoma treated by partial thyroid resection. Final histological diagnosis of 25 reoperations showed thyroid carcinoma in 22 (88%) cases and multinodular goiter in 3 cases. The overall interval between the initial and the reoperative procedures ranged from 3 weeks to 15 years. There was no post-operative mortality after reoperation. Post-operative complications were discovered in 5 patients, as 3 (12%) of whom had transient hypocalcaemia, one (4%) had wound breakdown and one (4%) had permanent recurrent laryngeal nerve palsy. Reoperative thyroid surgery is an uncommon operation with high complication rate. During the 6-year period from January 1996 to December 2001, 393 patients underwent primary thyroid operations at Hospital Universiti Sains Malaysia and reoperative thyroid surgery was performed on 25 (6.4%) patients. All patients had undergone one prior thyroid surgical operation. The records of all these patients including history, physical examination, operation, pathology reports and follow up visits were reviewed. In general, complications of reoperative thyroid surgery are higher than primary surgical procedure. But a total thyroidectomy will remove residual tumour in the remaining contralateral lobe of thyroid gland in 43% of patients. Total thyroidectomy prevents the recurrent disease in a multinodular goiter. In addition total thyroidectomy allows the patient to be scanned for residual thyroid remnant and distant metastases. The present study shows four percent permanent recurrent laryngeal nerve injury and twelve percent transient hypocalcaemia in patients after reoperative thyroid surgery. Complications were seen in both benign and malignant thyroid diseases. Reoperative thyroid surgery is an uncommon operation with increased morbidity. With careful attention to operative details to preserve the recurrent laryngeal nerves and the parathyroid glands, the complications can be minimized to an acceptable level. At the same time the advantages of total thyroidectomy has indicated that reoperative thyroid surgery is a feasible procedure in proper circumstances.
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