SURGICAL MANAGEMENT IN TREATMENT OF DIFFUSE TOXIC GOITRE
Keywords:thyroid gland, thyroidectomy, hyperthyroidism
Objectives. After surgical treatment of patients with diffuse toxic goitre, thyrotoxicosis recurs in 0.5-10% of cases, and hypothyroidism is marked in 50-84% cases. This fact argues for the intensification of research aimed at optimizing the results of surgical treatment. The aim of the study was to determine the efficiency of subtotal thyroidectomy in treatment of diffuse toxic goiter.
Material and Methods. During 2015-2020 period, Surgical Clinic no.2 of the State University of Medicine and Pharmacy "Nicolae Testemiţanu", Chișinău, Republic of Moldova, 159 patients with diffuse toxic goitre were operated. Male/female ratio was 31/128 (1:5), aged varied between 16 and 71 years. Patients underwent examination: hormone tests, ultrasonography, scintigraphy. Indications for surgery were: gland volume, no remission of drug treatment, frequent recurrence by altering the body's vital functions.
Results. All patients underwent subtotal thyroidectomy retouching thyroid paratraheal abutments (2±0.9 cm³). In the early postoperative period, the following complications were noted: wound hematoma – 3(1,8%) cases, transient dysphonia – 3(1,8%) cases, hypoparathyroidism – 1(1,6%) case. Of late complications were recorded – 6(3,77%) cases of recurrence of diffuse toxic goitre. Of all operated patients 81(50,9%) were subject to follow-up control for a period of 1-5 years. Of these 32(39,5%) have made a slight hypothyroidism 49(61,5%) - average hypothyroidism subsequently cleared medically
Conclusion. The obtained results show that subtotal thyroidectomy is the method of choice in the treatment of diffuse toxic goitre.
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