RESULTS OF SURGICAL TREATMENT OF NODULAR GOITER IN THE REGION OF ENDEMIC GOITER

Nodular goiter is a rare condition in children and adolescents and compared with adults, thyroid nodules are more frequent malignant in pediatric population. We have investigated the prevalence of thyroid carcinoma among the thyroid disorder emphasizing on the surgical treatment in term of indication, methods and complications. Retrospective study of 35 children and adolescents with nodular goiter. Demographic data, thyroid ultrasonographic features, fine needle biopsy aspiration, hormonal profile, surgical treatment procedure as well as histological aspects were recorded. Study included 26 (74%) girls and 9 (26%) boys with a mean age of 11.66 years. Fine needle aspiration biopsy was performed in 10 cases due to the TIRADS score � 4 with Bethesda II in 3 cases, Bethesda III in 4 cases and Bethesda V in 3 cases. The surgical treatment was performed in 16 (45.7%) cases due to fine needle aspiration biopsy results or due to the relapse after medical treatment. Lobectomy was performed in 7 (43.7%) cases while total thyroidectomy was the final option for the rest of 9 (56.3%) patients. As a result of pathological examination in 8 cases the thyroid carcinoma has been found. The rest of 8 patients presented benign thyroid findings (follicular adenoma, toxic adenoma and Graves� disease with follicular adenoma). The prevalence of thyroid carcinoma among the pediatric population with thyroid nodules was 22.8% most affected being the female gender.

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Medical and Surgical Treatment of Endemic Goiter

Textbook of Endocrine Surgery ◽

10.1016/b978-0-7216-0139-7.50007-7 ◽

2005 ◽

pp. 16-23 ◽

Cited By ~ 2

Author(s):

P CHEUNG

Keyword(s):

Surgical Treatment ◽

Endemic Goiter

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Monitoring And Evaluation Of Hemodynamic Parameters During Anesthesia In Endocrine Surgery

The American Journal of Medical Sciences and Pharmaceutical Research ◽

10.37547/tajmspr/volume02issue12-08 ◽

2020 ◽

Vol 02 (12) ◽

pp. 40-46

Author(s):

Joniev Sanjar Shuxratovich ◽

◽

Shukur Pardaev Kuylievich ◽

Akramov Bahodir Raxmonovich ◽

Hushvakov Ulmas Oftedal Ugli ◽

...

Keyword(s):

Surgical Treatment ◽

Nodular Goiter ◽

Monitoring And Evaluation ◽

Endocrine Surgery ◽

Hemodynamic Parameters ◽

Preoperative Period ◽

Preoperative Preparation ◽

New Approach ◽

Toxic Nodular Goiter ◽

Modified Method

The article presents the results of preoperative preparation, anesthesia and surgical treatment of patients operated on for non-toxic nodular goiter. A new approach to preoperative preparation for thyroid surgery is described. The effectiveness in the preoperative period of using the modified method of preoperative preparation using sibazon and droperidol and anesthesia with the use of ketamine and the advantages of this method compared with other methods of general anesthesia are shown.

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Results of sclerotherapy for recurrent and non-recurrent nodular goiter

Medical and Social Expert Evaluation and Rehabilitation ◽

10.17816/mser49857 ◽

2020 ◽

Vol 23 (3) ◽

pp. 24-30

Author(s):

Gю V. Rodoman ◽

T. I. Shalaeva ◽

I. R. Sumedi ◽

N. V. Sviridenko ◽

M. M. Meloyan

Keyword(s):

Surgical Treatment ◽

Thyroid Tissue ◽

Nodular Goiter ◽

Good Alternative ◽

Alternative Methods ◽

Recurrent Goiter ◽

Rehabilitation Period ◽

History Of ◽

Functional Autonomy ◽

The Cost

Background. The problems of treating recurrent nodular goiter are still relevant. The technical difficulties of the intervention on the neck tissues altered by the scarring process and the comorbid background of patients cause an unacceptably high risk of complications of traditional surgical treatment and, as a result, a long and difficult rehabilitation period and high costs for the treatment of patients who have undergone surgery for recurrent goiter. Alternative methods, such as sclerotherapy, which reduce the risk of complications, have been successfully used in patients with non-operated thyroid, but the possibilities of minimally invasive destruction of recurrent nodules have not been studied enough, and it is not known whether it is as safe and effective as sclerotherapy of non-recurrent nodules. The aim of the study was to compare the efficacy and safety of treatment of recurrent and non-recurrent nodular goiter using sclerotherapy. Materials and methods. The study included 30 previously not operated patients with nodular goiter and 30 patients with recurrent nodular goiter. All of them underwent 4 courses of sclerotherapy, each of which included 5 sessions with a frequency of 1 session per week; polidocanol was used as a sclerosant. Results. The analysis showed that the efficiency of reduction of nodules did not decrease in patients with recurrent goiter, despite severe sclerotic changes in the tissues. The size of the nodules and the volume of thyroid tissue were reduced during sclerotherapy, regardless of the presence of a history of thyroid surgery, as well as the cure of functional autonomy and relief of symptoms of neck compression. The tolerability of sclerotherapy also did not depend on the presence of recurrent goiter, and the rate of complications was the same (0.8%). Complications of sclerotherapy were not serious in any case. Conclusions. Thus, sclerotherapy of recurrent nodules is a good alternative to traditional surgical treatment; it is not inferior in efficiency and safety to sclerotherapy of nodules in a non-operated thyroid. Its use will significantly reduce the rehabilitation period and the cost of treating patients with recurrent nodular goiter.

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Thyroid Dysfunction and Cytological Patterns among Patients Requested for Thyroid Function Test in an Endemic Goiter Area of Gondar, North West Ethiopia

International Journal of Endocrinology ◽

10.1155/2019/9106767 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Daniel Asmelash ◽

Kumlgn Tesfa ◽

Belete Biadgo

Keyword(s):

Thyroid Function ◽

Thyroid Dysfunction ◽

Endemic Goiter ◽

Wide Spectrum ◽

Nodular Goiter ◽

Thyroid Function Test ◽

Subclinical Hyperthyroidism ◽

Cross Sectional ◽

Function Test ◽

Study Participants

Background. Thyroid dysfunction is the most common endocrine disorder in clinical practice, and about half of the population with thyroid dysfunction remains undiagnosed. There is a fairly wide spectrum of thyroid dysfunction, which can be identified by patterns of thyroid function test results. The prevalence of thyroid dysfunction among the population varies in different studies. Methods. A cross-sectional study was conducted from February 8th to April 8th, 2017, among patients who requested for the thyroid function test in an endemic goiter area at the Gondar Hospital, University of Gondar. A pretested structured questionnaire was used to collect the data. Three milliliters of blood samples was collected in a plain test tube and centrifuged for serum separation. The thyroid function test was done by using the MINI-VIDAS automation following the manufacturer manual (Setema PLC, Italy). Data were entered and analyzed using SPSS version 20. Descriptive statistics were used for data presentation, and P value < 0.05 was considered significant. Result. Of the total 384 study participants, 346 (90.1%) were females and the study participants’ mean age was 38 ± 13.9 years. The overall thyroid dysfunction prevalence was 26.3% (101): 1.6% was identified as subclinical hypothyroidism, 0.5% hypothyroidism, 9.6% subclinical hyperthyroidism, and 14.6% hyperthyroidism, and 23.4% had goiter. Furthermore, for cytological pattern analysis, 144 study participants who fulfilled indications for fine-needle aspiration cytology (FNAC) in thyroid nodules were included. Of the total, 3 (2.1%) had thyroid carcinoma, 46 (32%) had cystic degenerated follicular cells, and 82 (57%) had nodular thyroid goiter. In addition, a clinical presentation of a total of 144 study participants, showed lymphadenites in 7 participants (4.8%), hypertension in 9 (6.2%), and cardiac failure in 12 (8.3%). Conclusion. The prevalence of thyroid dysfunction was high. The majority of thyroid dysfunction cases were newly diagnosed and more common in females. In addition, the most common disorders were subclinical hyperthyroidism and hyperthyroidism. Follicular cell with cyst degeneration and thyroid nodular goiter were the predominant FNAC findings. For early diagnosis and appropriate intervention in goiter endemic areas, the thyroid function test should be closely monitored.

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Peculiarities of operative treatment of goiter on background of autoimmune thyroiditis

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2020.1-2.43 ◽

2020 ◽

Vol 87 (1-2) ◽

pp. 43-46

Author(s):

O. P. Kovalov ◽

O. M. Liulka ◽

V. I. Liakhovskyi ◽

I. I. Nemchenko ◽

A. V. Sydorenko

Keyword(s):

Surgical Treatment ◽

Thyroid Gland ◽

Autoimmune Thyroiditis ◽

Malignant Tumors ◽

Laboratory Data ◽

Clinical Signs ◽

Endocrine System ◽

Nodular Goiter ◽

Subtotal Resection ◽

Retrosternal Goiter

Objective. To determine the peculiarities of operative technique in surgical treatment of patients with nodular goiter on background of autoimmune thyroiditis. Materials and methods. The results of surgical treatment of nodular goiter, basing on data from surgical clinic of the Second Clinical Hospital in City of Poltava through 2003 - 2017 yrs were adduced. There were operated 549 patients, suffering nodular goiter. There were 58 (10.6%) men and 491 (89.4%) women. Unilateral nontoxic nodular goiter was observed in 187 (34.1%) patients, multinodular nontoxic – in 322 (58.7%), multinodular toxic – in 30 (5.5%), thyreotoxic adenoma – in 21 (3.8%) patients. Cervico-retrosternal goiter was in 110 (20.0%) patients. For recurrent goiter 21 (3.8%) patients were operated. Malignant tumors were revealed intraoperatively or after definite histological investigation in 22 (4/0%) patients. Of 108 patients, to whom, basing on the disease clinical signs, laboratory data and preoperative cytological investigation the diagnosis of nodular goiter on background of autoimmune thyroiditis was established, while performing of definite postoperative investigation macromicrofollicular colloidal goiter was revealed in 41 (38%), nodular goiter with the autoimmune thyroiditis – in 51 (47.2%), cancer (papillary, follicular) – in 8 (14.8%) patients. Subtotal resection of thyroid gland was performed in 8 (15.7%) patients, hemithyroidectomy - in 12 (23.5%), extrafascial thyroidectomy – in 23 (45.1%). In patients, suffering thyroidal gland cancer, extrafascial thyroidectomy was performed, while in 3 – with central lymphodissection. Intraoperatively visual macroscopic estimation of thyroid gland and obligatory suboperative cyto- and histological investigations of the specimen obtained were performed. Operative tactics was applied in accordance to actual clinical protocols for treatment of patients, suffering surgical pathology of endocrine system. Results. Some technical measures were proposed to minimize the risk of injury of anatomic structures: lower laryngeal nerve, parathyroidal glands, trachea, the neck vessels. Conclusion. Extrafascial procedure guarantees a visual control in the risk zones and radicality of operation, minimizes the specific complications rate.

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SIMULTANEOUS OPERATIONS FOR LIVER ECHINOCOCCOSIS

Novosti Khirurgii ◽

10.18484/2305-0047.2021.1.13 ◽

2021 ◽

Vol 29 (1) ◽

pp. 13-19

Author(s):

M.Zh. Aliev ◽

◽

L.M. Zubekhina ◽

K.I. Niiazbekov ◽

N.V. Tushina ◽

...

Keyword(s):

Surgical Treatment ◽

Ultrasound Examination ◽

Nodular Goiter ◽

Bile Leakage ◽

X Ray ◽

Abdominal Organs ◽

Simultaneous Operations ◽

Liver And Kidney ◽

Chest X Ray

Objective. To evaluate the results and effectiveness of simultaneous operations for echinococcosis of the liver. Methods. Surgical diseases requiring surgical treatment (cholelithiasis: calculus cholecystitis, choledocholithiasis, nodular goiter, ventral postoperative hernia) were detected in 38 patients with echinococcosis of the liver. 23 patients underwent organ-preserving operations for echinococcosis, and 15 patients underwent radical operations, all operations were perfomed in combined with cholecystectomy, choledocholitotomy, thyroidectomy, and herniotomy (coating of a polypropylenemesh for hernia gate).Immediate and remote results were studied. Patients were reexamined 6 months after surgery within a 3-year period. The examination included the checkup, general blood test, liver and kidney tests, an ultrasound examination of the abdominal organs, and a chest x-ray once a year. Results. During theimmediate postoperative period 4 patients out of 38 (10.5%) had complications. After simultaneous operations using organ-preserving methods of echinococcectomy, 2 patients out of 23 (8.7%) had complications (pleuritis, wound suppuration), and 2 - out of 15 had radical operations (bile leakage, pleuritis). All complications had been cured by the time of discharge. The remote results were studied over a period of 6 months to 3 years. 34 patients were examined up to 1 year, 31 - from 1 to 2 years, 26 - from 2 to 3 years. Within the examination and follow-up periods no recurrence of echinoccosis was observed. Conclusion. During simultaneous operations and the echinococcectomy of the liver it is necessary to observe accurately the rules of aparasiticity and antiparasiticity.Simultaneous operations for the liver echinococcosis should be performed according to strict indications and by a highlyexperiencedandqualified surgeon. Patients who have undergone simultaneous operations was asked toundergoa medicalcontrol examination at least once a year. What this paper adds The possibility of performing simultaneous operations for echinococcosis of the liver has been defined. The sequence of operations for echinococcosis in combination with other pathologies requiring surgical treatment has been justified.

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Prognosis of remote results of surgical treatment of nodular endemic goiter with autoimmune thyroiditis

Acta Medica Leopoliensia ◽

10.25040/aml2019.01.008 ◽

2019 ◽

Vol 25 (1) ◽

pp. 8-16

Author(s):

M.I. Sheremet ◽

◽

V.O. Shidlovskyi ◽

N.P. Tkachuk ◽

O.V. Shidlovskyi ◽

...

Keyword(s):

Surgical Treatment ◽

Autoimmune Thyroiditis ◽

Endemic Goiter

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SURGICAL TREATMENT OF PATIENTS WITH FOLLICULARTUMOR OF THYROID GLAND

HERALD of North-Western State Medical University named after I I Mechnikov ◽

10.17816/mechnikov20146412-15 ◽

2014 ◽

Vol 6 (4) ◽

pp. 12-15

Author(s):

S A Simbirtsev ◽

V V Tatarkin ◽

E M Trunin ◽

A A Smirnov ◽

D V Davidov ◽

...

Keyword(s):

Surgical Treatment ◽

Thyroid Gland ◽

Malignant Tumor ◽

Nodular Goiter ◽

Thyroid Tumors ◽

Treatment Results ◽

Nontoxic Goiter ◽

Gender And Age ◽

Treatment Safety ◽

Follicular Thyroid Tumors

In this work, based on the research of treatment results of 646 patients that were operated for nodular and multinodular nontoxic goiter in Hospital St. Elizabeth endocrinology center, in the period from 1997 to 2013, an analysis of the malignant tumor frequency in patients with follicular thyroid tumors who underwent surgical treatment for the nodular goiter was performed. In this group gender and age characteristics of patients with follicular thyroid tumors were identified, and also an evaluation of surgical treatment safety in patients operated for follicular thyroid tumors was performed.

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