Open AccessSurgical treatment of patients with nodular toxic goiter
Author(s) -
S. M. Zavhorodnii,
М. С. Гатіа,
Mikhail Anatolyevich Kubrak,
M. B. Danyliuk
Publication year - 2021
Publication title -
zaporožskij medicinskij žurnal
Language(s) - English
Resource type - Journals
eISSN - 2310-1210
pISSN - 2306-4145
DOI - 10.14739/2310-1210.2021.3.229724
Subject(s) - medicine , thyroidectomy , surgery , goiter , multinodular goiter , levothyroxine , thyroid , abdominal surgery , population , environmental health
Nodular toxic goiter (NTG) accounts for 7.3 % to 10.0 % of the goiter population. There are difficulties in the preoperative differential diagnosis between NTG and other thyroid diseases. There is also controversy about the benefits of resection surgery over thyroidectomy in patients with NTG.The aim of the study: a comparative assessment of the diagnosis and treatment results of patients with NTG in the early and late postoperative periods after resection surgery and thyroidectomy.Materials and methods. The study enrolled 51 patients with NTG. The mean age of patients in the group was 51.7 ± 12.9 years.Results. Bilateral multinodular lesions prevailed – 34 (66.7 %) patients. Free T3 level was measured only in 15 (29.4 %) patients, 7 (46.7 %) of them had elevated T3 level. 15 (29.4 %) patients underwent hemithyroidectomy including the isthmus, 2 (3.9 %) had subtotal resection, 34 (66.7 %) patients underwent thyroidectomy.Conclusions. Multinodular bilateral thyroid lesions dominated the structure of NTG – 34 (66.7 %) patients who underwent thyroidectomy. Uninodular and multinodular unilateral pathology was diagnosed only in 17 (33.3 %) patients who underwent organ-preserving surgery. The measurements of free T3 level in patients with NTG allowed the diagnosis of T3-thyrotoxicosis in almost half of patients (46.7 %), which is a diagnostic criterion for detection of functional nodal autonomy. Following the organ-preserving surgery, 17 (33.3 %) patients with NTG required the use of hormone replacement therapy with levothyroxine at a mean dose of 25.0 (25.0; 50.0) mcg/day in the late postoperative period (>1 year).