Surgical treatment of patients with nodular toxic goiter

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.3.229724

Keywords:

nodular toxic goiter, endocrine diseases, surgery

Abstract

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).

Author Biographies

S. M. Zavhorodnii, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of General Surgery and Postgraduate Surgical Education

M. S. Gatia, Zaporizhzhia State Medical University, Ukraine

MD, Postgraduate student of the Department of General Surgery and Postgraduate Surgical Education

М. А Kubrak, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of General Surgery and Postgraduate Surgical Education

M. B. Danyliuk, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assistant of the Department of General Surgery and Postgraduate Surgical Education

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Published

2021-06-07

How to Cite

1.
Zavhorodnii SM, Gatia MS, Kubrak МА, Danyliuk MB. Surgical treatment of patients with nodular toxic goiter. Zaporozhye Medical Journal [Internet]. 2021Jun.7 [cited 2024Nov.23];23(3):370-4. Available from: http://zmj.zsmu.edu.ua/article/view/229724

Issue

Vol. 23 No. 3 (2021)

Section

Original research

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