2. Modern Principles Of Surgery Treatment Of Patients With Nodular Goiter

Authors

  • O.M. Osmanov State Budgetary Institution of Healthcare “Clinical City Hospital №67”, Moscow, Russia
  • M.M. Magomedov Federal State Budgetary Educational Institution of Higher Education «Dagestan state medical university», Department of surgery, faculty of advanced training and professional retraining of specialists with the course of endoscopic surgery, Makhachkala, Republic of Dagestan, Russia

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Abstract

Purpose of the study. To justify and confirm the differentiated approach to choosing the volume of surgical inter-vention in benign nodular goiter..

Materials and methods. A prospective analysis of 180 patients who underwent thyroid surgery was performed; 11 (6.1%) were men and 169 (93.9%) were women aged 20-65 years. The duration of the patients’ disease was 8 months to 12 years. All patients with benign non-toxic goiter underwent a thorough evaluation of changes in the level of thyroid hormones in serum, ultrasound of the thyroid gland, and aspiration biopsy of the thyroid gland..

Results. In laboratory studies, a high level of malignancy is observed in patients with higher levels of TSH and antibodies, TG and antibodies, TPO. There were no significant differences in the values of T3 and T4. In the ultrasound study, the average and maximum diameter of malignant nodes were significantly smaller than that of benign ones (1.99 ± 1.88 cm; p < 0.001). The difference between surgical procedures described as subtotal, total, and hemi-thyroidectomy was statistically significant. In 128 (71.1%) patients nodes were located in one lobe, 68 (37.8%) patients had multiple nodes, and 52 (28.9%) had solitary nodes in one of the thyroid lobes. In-traoperatively, 68 (37.7%) patients underwent cytomorphological examination of removed thyroid tissue. Hemithyroidectomy was performed in only 57 (31.6%) patients. Subtotal thyroidectomy was performed in 78 (43.3%) patients, and total thyroidectomy was performed in 45 (25%) pa-tients. With the development of hematoma, one patient was re-operated after total thyroidectomy. Hypoparathyroidism was diagnosed in 2 (4.4%) patients after thyroidectomy, and in 1 (1.3%) patient after subtotal thyroidectomy. 3 patients had transient laryngeal paresis after thyroidectomy. Hypothyroidism developed in 14 (24.6%) patients after hemithyroidectomy, in 50 (64.1%) patients after subtotal thyroidectomy and in 45 (100%) after thyroidectomy..

Conclusion. The decision of surgical intervention should be differentiated with respect to the choice of surgical intervention tactics.

Keywords

thyroidectomy, subtotal thyroid-ectomy, hemithyroidectomy, hypothyroidism

References

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Published

2021-05-21

Issue

No. 1 (2021)

Section

Статьи