Within a prospective multicenter study for quality assessment of goiter surgery that was participated by 45 East German hospitals from January 1 through December 31 in 1998, postoperative complications were investigated in dependance on performing a Ligation of inferior thyroid artery (peripheral ligation of the branches vs. central ligation at the trunk vs. no ligation at all) in case of bilateral resection for benign goiter. 7265 patients ( 5600 male, 1661 female, 4 times no data) with a mean age of 51,8 years were included. Complication rates were tested using the Chi2- test. The most important complications (recurrent laryngeal nerve pulsy, hypoparathyroidism, postoperaive bleeding, wound infection) additionally were investigated by multivariate analysis. Intraoperative bleeding and transfusion rates were significantly lower in operations with performing ligation of the trunk or the branches than in operations without any ligation of the inferior thyroid artery. Central ligation increased risk for permanent hypoparathyroidism in uni - and multivarite analysis. In cases of toxic goiter central ligation proved to be an protective factor to avoid postoperative bleeding. The different methods concernig the procedure of ligation did not significantly affect the incidence of permanent laryngeal nerve pulsy. Consequently peripheral ligation af the branches of the artery seems to be the procedure of choice, particularly because of achieving smallest residual volumes after bilateral subtotal resections. |