Khirurgiia · 2013
Selective or radical surgical strategy in functional autonomy of the thyroid in endemic areas.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Pandev R, Kouzi A, Cherkezov G, Damyanov D
Аннотация
BACKGROUND: The purpose of the research is to compare two surgical methods in the treatment of functional autonomy of the thyroid regarding postsurgical complications and functional results.
METHODS: 212 patients were examined--divided into two groups. Group 1 (n = 148)--in which selective thyroid resection have been done and Group 2 (n = 64)--in which radical resection have been undertaken.
RESULTS: For both groups the following postoperative complications have been determined: In 4 (1.8%) patients transitory recurrent palsy is determined and in 1 (0.5%) patient-permanent recurrent palsy. The frequency of the transitory hypoparathyroidism is 7.5% (n = 16) and that of the permanent hypoparathyroidism is 0%. 148 patients from the two groups were followed up with respect to the functional results obtained at the eight postsurgical week and from 1 to 7 years after the operation. In the selective group (eight postsurgical week) 3 from the patients were with hyperthyroidism and 4 with hypothyroidism. From 1 to 7 years after the operation the following functional results have been determinated: in 7 patients relapse of the hyperthyroidism, in 8 patients new hypothyroidism and in 3 patients- morphological recurrence In radically operated patients the frequency of the postsurgical hypothyroidism during the 8 postsurgical week was 50% (n = 26). For the period from 1 to 7 years after the operation the following functional results were observed: 1 patient with relapse of hypothyroidism, 11 patients with new hypothyroidism. Not one morphological recurrence was observed.
CONCLUSIONS: The residual and recurrent hyperthyroidism are related to the insufficient extent of resection. A functionally confirmed surgical strategy has been imposed in the endemic areas striving to remove all nodular structures at the same preserving the normal thyroid tissue.
METHODS: 212 patients were examined--divided into two groups. Group 1 (n = 148)--in which selective thyroid resection have been done and Group 2 (n = 64)--in which radical resection have been undertaken.
RESULTS: For both groups the following postoperative complications have been determined: In 4 (1.8%) patients transitory recurrent palsy is determined and in 1 (0.5%) patient-permanent recurrent palsy. The frequency of the transitory hypoparathyroidism is 7.5% (n = 16) and that of the permanent hypoparathyroidism is 0%. 148 patients from the two groups were followed up with respect to the functional results obtained at the eight postsurgical week and from 1 to 7 years after the operation. In the selective group (eight postsurgical week) 3 from the patients were with hyperthyroidism and 4 with hypothyroidism. From 1 to 7 years after the operation the following functional results have been determinated: in 7 patients relapse of the hyperthyroidism, in 8 patients new hypothyroidism and in 3 patients- morphological recurrence In radically operated patients the frequency of the postsurgical hypothyroidism during the 8 postsurgical week was 50% (n = 26). For the period from 1 to 7 years after the operation the following functional results were observed: 1 patient with relapse of hypothyroidism, 11 patients with new hypothyroidism. Not one morphological recurrence was observed.
CONCLUSIONS: The residual and recurrent hyperthyroidism are related to the insufficient extent of resection. A functionally confirmed surgical strategy has been imposed in the endemic areas striving to remove all nodular structures at the same preserving the normal thyroid tissue.