Surgical treatment of unilateral nodular goiter with compression syndrome in patients with autoimmune thyroiditis

Aim — todetermine indications for the choice of the surgery scope in patients with unilateral nodular goiter with compression syndrome against the background of autoimmune thyroiditis (AIT) and possibility of prognosis of the long-term results of surgical treatment.Materials and methods. The analysis has been performed for the long-term results of hemithyroidectomy in 101 femalepatients aged 23 to 72 years with unilateral nodular goiter against the background of AIT (NGAIT) with compression syndrome. The pre-operational levels of the following parameters, definingsatisfactory and unsatisfactory treatment results, have been analyzed: volume of the lobe of the gland, blood levels of thyroid stimulating hormone, free thyroxine and triiodothyronine, antibodies to thyroid peroxidase, indices of apoptosisand proliferation, variants ofechostructure.Results. Satisfactory results have been established in 75 patients based on the following results of examinations 3 years after hemithyroidectomy: no violations of thyroid gland functional state, andno progression of preoperative AIT signs or progression without hypothyroidism and changesin ultrasound picture in the parenchymaof the remaining lobe of the gland according to the data of ultrasound investigation.Unsatisfactory results were definedin 26 subjects: an increase in the volume of the remaining thyroid gland and the progression of autoimmune process with the development of hypothyroidism. A satisfactory result of hemithyroidectomy in the treatment of patients with NGAIT with compression syndrome can be expected in cases where at the time of surgery the volume of the lobe was not more than 12.7 cm3, its echostructure corresponded to hypoechoic and heterogeneous and pseudomicronodular variants, and the following blood levels were established: thyroid stimulating hormone < 2.85 IU/L, free thyroxine > 16.7 pmol/l, free triiodothyronine > 5.3 pmol/l, antibodies to thyroid peroxidase < 137 IU/ml.Conclusions. One of the possible options for surgical treatment of patients with unilateral nodular goiter against the background of AIT with compression syndrome may be hemithyroidectomy in conditions of preserved hormonal function of the gland with moderately pronounced processes of proliferation and apoptosis, structural changes in the parenchyma at the level of hypoechoic and heterogeneous and pseudomicro-nodal echostructural variants. The use of hemithyroidectomy is contraindicatedin cases of pseudo-large-nodular and more severe variants of the echostructure of the thyroid parenchyma, regardless of the indicators of hormone-producing function, antibodies to thyroid peroxidase, proliferation and apoptosis.

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Indications for hemithyroidectomy for nodular goiteragainst the background of autoimmune thyroiditis and prognosis of long-term results

Clinical endocrinology and endocrine surgery ◽

10.30978/cees-2021-3-14 ◽

2021 ◽

pp. 14-20

Author(s):

А. V. Shidlovskyi ◽

V. А. Shidlovskyi ◽

M. I. Sheremet ◽

A. V. Lazaruk ◽

O. H. Netsiuk ◽

...

Keyword(s):

Thyroid Gland ◽

Satisfactory Result ◽

Autoimmune Thyroiditis ◽

Structural Changes ◽

Free Thyroxine ◽

Long Term Results ◽

Blood Levels ◽

Thyroid Peroxidase ◽

Compression Syndrome

Aim — to study the possibility of determining the indications for choice of the extent of surgery in patients with unilateral nodular goiteragainst the background of autoimmune thyroiditis(AIT) with compression syndrome and prognosis for the long-term results of surgical treatment.Materials and methods. The analysis has been performed for the long-term results of hemithyroidectomy in 101 women aged from 23 to 72, patients with unilateral nodular goiteragainst the AITbackground with compression syndrome. It has been established what exactly indications to the surgery,includingvolume of the gland, echostructure variant, blood levels of thyroid stimulating hormone(TSH), free thyroxine and triiodothyronine, thyroid peroxidase(TPO) antibodies, apoptosis and proliferation indicators, provided satisfactory and unsatisfactory treatment results.Results. Based on the results of investigation in 3 years after hemithyroidectomy, no violations of the functional state of the thyroid glandwere revealed in 75 patients; in them ultrasoundinvestigation of parenchyma of the remaining lobe of the gland showed that pre-operativeAITsigns did not progress or progressed without hypothyroidism and changes of the variant of ultrasound picture (satisfactory result). In 26 patients an increase in the volume of the remaining part of the thyroid gland and progression of the autoimmune process with the development of hypothyroidism were established (unsatisfactory result).One can expect the satisfactory result of hemithyroidectomy in the treatment of patients with unilateral nodular goiteragainst the AIT backgroundwith compression syndrome in cases where at the time of surgery the volume of the lobe does not exceed 10 cm3, its echostructure corresponds to hypoechoic and heterogeneous and pseudomicronodular variants, TSH is not higher than 2.85 IU/L, levels of free thyroxine and triiodothyronine are not lower than 16.7 and 5.3 pmol/l, respectively, TPO antibodies level is not higher than 150 IU/ml.Conclusions. One of the possible options for surgical treatment of patients with unilateral nodular goiteragainst the AIT background with compression syndrome may be hemithyroidectomy with preserved hormonal function of the gland and structural changes in the parenchyma in the lobe, which remains at the level of hypoechoic and heterogeneous or pseudomicrous variants. Hemithyroidectomy is contraindicated in cases of pseudolarge nodular and severe variants of parenchyma echostructure of the thyroid gland.

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PRIMARY-MULTIPLE TUMORS IN PATIENTS WITH NEOPLASMS OF THYROID GLAND

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2015-174-2-70-76 ◽

2015 ◽

Vol 174 (2) ◽

pp. 70-76

Author(s):

A. F. Romanchishen ◽

K. V. Vabalaite

Keyword(s):

Surgical Treatment ◽

Thyroid Gland ◽

Thyroid Carcinoma ◽

Chemical Nature ◽

Malignant Tumors ◽

Long Term Results ◽

Occupational Hazard ◽

Other Neoplasms

The authors studied the long-term results of surgical treatment of 949 patients with thyroid carcinoma. The malignant tumors of other organs were revealed in 55 (5,8%) cases during 20 years of follow-up. It was stated that patients with thyroid carcinoma had a higher risk of developing other malignant tumors than in population. A typical background for onset of other neoplasms was a latent hypothyroidism, hyperlipidemia, hypersecretion of gonadotropins, an influence of occupational hazard of chemical nature and hereditary load of oncology.

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THE NEAREST AND LONG-TERM RESULTS OF SURGICAL TREATMENT OF FOCAL PATHOLOGY OF THE THYROID GLAND

Journal of Volgograd State Medical University ◽

10.19163/1994-9480-2020-1(73)-106-110 ◽

2020 ◽

Vol 73 (1) ◽

pp. 106-110

Author(s):

Z.M. Sigal ◽

◽

, O.V. Surnina ◽

V.V. Bryndin ◽

O.A. Sigal ◽

...

Keyword(s):

Surgical Treatment ◽

Thyroid Gland ◽

Long Term Results

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Afterhistory of surgical treatment of nodular goiter

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2007-4-100-104 ◽

2007 ◽

Vol 6 (4) ◽

pp. 100-104

Author(s):

V. G. Petrov ◽

D. I. Malinin

Keyword(s):

Surgical Treatment ◽

High Probability ◽

Nodular Goiter ◽

Long Term Results ◽

Subtotal Resection ◽

Recurrent Goiter

Long-term results of surgical treatment of 649 patients with different morphological forms of nodular goiter in terms of 15 to 3 years are analyzed. Postsurgical recurrent goiter was diagnosed in 26.8% (174 people). The most part of relapses falls on operations characterized by the large part of TG tissue rest (resection of TG lobe and node enucleation): 69.1% (139 patients of 201). No one relapse was diagnosed after thyreoidectomy. After extremely subtotal resection, relapses were observed in 2.2% (7 people of 312) and after hemithyroidectomy in 20.6% (26 people of 136). This study indicates inadequacy of operations such as node enucleation and resection of the lobe with a node, especially, if the node belongs to nodular colloid goiter, because in such operations the pathologically changed TG tissue is often rest and there is high probability of relapse.

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Surgical treatment of trigonocephaly: technique and long-term results in 48 cases

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2011.05.060 ◽

2011 ◽

Vol 2011 ◽

pp. 282

Author(s):

P. Klimo

Keyword(s):

Surgical Treatment ◽

Long Term Results

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Long-term results of radiofrequency ablation used for the surgical treatment of atrial fibrillation associated with rheumatic mitral valve disease

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0029-1191713 ◽

2009 ◽

Vol 56 (S 01) ◽

Author(s):

I Tzanavaros ◽

I Bergfeld ◽

A Rajca ◽

V Herwig ◽

A Heyde ◽

...

Keyword(s):

Atrial Fibrillation ◽

Surgical Treatment ◽

Radiofrequency Ablation ◽

Mitral Valve ◽

Mitral Valve Disease ◽

Valve Disease ◽

Long Term Results

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Temporary “liquid” Implant for Congenital Glaucoma (long-term results)

International scientific-practical journal Ophthalmology ◽

10.30702/ophthalmology30092020-11.1.2049-65 ◽

2020 ◽

pp. 49-65

Author(s):

N Bobrova ◽

N Trofimova

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Hypotensive Effect ◽

Congenital Glaucoma ◽

Long Term Results ◽

General Will ◽

Visual Functions ◽

Advanced Stages ◽

Intraocular Fluid

The aim of the work was to analyze the long-term results of using a temporary “liquid” implant in the surgery of congenital glaucoma in children. The basis of the developed method of filtrative antiglaucomatous surgery (Patent of Ukraine No. 45099 of 2009) – viscosinusotrabeculotomy – has been set the task of reducing the risk of developing intra- and postoperative complications, reducing the scarring rate and maintaining the newly created ways of the intraocular ﬂuid outﬂow, which in general will increase the effectiveness of surgical treatment of congenital glaucoma in children. 54 children (91 eyes) with simple congenital glaucoma at the age of 1 to 36 months were operated on average (8.7 ± 8.2) months. The persistent and long-lasting hypotensive effect achieved due to viscosinusotrabeculotomy in children with developed and far-advanced stages of congenital glaucoma stops the processes of stretching of the membranes of the eye and stabilizes their size, which in general allows preserving and visual functions improving, in infancy – creating conditions for their formation.

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SIMULTANEOUS ESOPHAGO-GASTRECTOMY WITH COLONIC INTERPOSITION AS A METHOD OF SURGICAL TREATMENT OF GASTROESOPHAGEAL CANCER WITH HIGH INVOLVEMENT OF THE ESOPHAGUS

Problems in oncology ◽

10.37469/0507-3758-2017-63-1-146-152 ◽

2017 ◽

Vol 63 (1) ◽

pp. 146-152

Author(s):

Mikhail Ter-ovanesov ◽

Aleksandr Levitskiy ◽

E. Lesnidze ◽

Aram Gaboyan ◽

Mariya Kukosh ◽

...

Keyword(s):

Surgical Treatment ◽

Long Term Results ◽

Esophageal Reconstruction ◽

Gastroesophageal Cancer ◽

Colonic Interposition ◽

Simultaneous Application ◽

High Involvement ◽

Surgical Access ◽

Critical Overview

In the current oncological practice surgical treatment of gastroesophageal cancer with high involvement of the esophagus can extend to total esophago-gastrectomy with colonic interposition as the main method of radical treatment. However the technical complexity and high risk of the intervention are factors in determining the divergent views on the operation itself, testimony for the criteria of patient’s selection, choice of surgical access and the formation of a colonic graft in conjunction with method of esophageal reconstruction. The long-term results of operative intervention depend primarily on the extent of tumor process but obviously higher than after conservative treatment. This article presents a brief critical overview of the main aspects of the simultaneous application of esophago-gastrectomy in surgery of gastroesophageal cancer with high esophageal involvement and our clinical case of successful surgical treatment of a woman with pregnancy-associated gastroesophageal cancer.

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