WAYS TO IMPROVE THE RESULTS OF SURGICAL TREATMENT OF DIFFUSE TOXIC GOITER
This article discusses the problems of surgical tactics in diffuse toxic goiter and its complications both in the early postoperative period and in the long-term period. The above mentioned complications push surgeons to find a more optimal method of surgical treatment.
Aim: To improve the results of surgical treatment of patients with diffuse toxic goiter by differentiated application of surgical tactics.
Materials and methods of research: From 2016 to September 2021, 70 patients with diffuse toxic goiter were operated on in the surgical department of the University Hospital NAO "Semey Medical University", the age of patients ranged from 21 to 62 years. The average age of the patients was 36±8. Among them 56 (80%) women and 14 (20%) men. All patients are 100% of working age.
Results. In the early postoperative period, the following complications were revealed: paresis of the vocal cords in 1 (1.9%) patients, bleeding in 3 (5.8%) patients, thyrotoxic crisis in 3 (5.8%). Together with the endocrinologist, anesthesiologist-resuscitator, ENT doctor, these complications were stopped. There was no fatal outcome.
Conclusions: In our practice, we performed thyroid embolization in 18 (25.7%) patients who had a full recovery. There were no fatalities.
Meyrbek Zh. Aimagambetov1, https://orcid.org/0000-0003-4699-8200
Nazarbek B. Omarov2, http://orcid.org/0000-0002-6201-8263
Altai A. Dyussupov 3, https://orcid.org/ 0000-0003-0875-1020
Yerasyl A. Mukash1, https://orcid.org/0000-0002-3337-7643
Tolkyn А. Bulegenov1, http://orcid.org/0000-0001-6145-9649
Samatbek T. Abdrakhmanov1, https://orcid.org/0000-0002-4270-3498
Medet A. Auyenov1, https://orcid.org/0000-0002-1809-9091
Andrey N. Zharikov4, https://orcid.org/0000-0003-4292-4781
Gauhar A. Korganbaeva5, https://orcid.org/0000-0001-5257-1495
Shyngys O. Orynbasarov6, https:// orcid.org/0000-0002-9321-1426
1 NСJSC «Semey Medical University», Department of Hospital and Pediatric Surgery,
Semey, Republic of Kazakhstan;
2 University Hospital t NСJSC «Semey Medical University», Semey, Republic of Kazakhstan;
3 Chairman of the Board – Rector NСJSC «Semey Medical University», Semey, Republic of Kazakhstan;
4 Altai State Medical University of the Ministry of Health of Russia, Barnaul, Russian Federation;
5 NСJSC «Semey Medical University», Department of Anatomy, Histology, Topographic Anatomy named after Professor N. A. Khlopov, Semey, Republic of Kazakhstan.
6 NСJSC «Semey Medical University», Department of Military Training, Semey, Republic of Kazakhstan.
1. Аймагамбетов М.Ж., Омаров Н.Б., Масалимов Е.О., Аужанов Д.Б. и др. Наш опыт лечения диффузно-токсического и узлового зоба // Наука России: цели и задачи. 2020. №3, С. 54-56.
2. Есбергенова М.Ж., Заманбекова Ж.К., Уватаева Ж.С. и др. Состояние щитовидной железы у населения районов, прилегающих к бывшему Семипалатинскому испытательному ядерному полигону // Наука и Здравоохранение 2014. № 5. С. 28-29.
3. Affleck B.D., Swartz K., Brennan J. Surgical considerations and controversies in thyroid and parathyroid surgery // Otolaryng Clin N Am. 2004. 36:159–88.
4. Bartalena L., Marcocci C., Bozaggi F., Panicucci M., Lepri A., Pinchera A., et al. Relation between therapy for hyperthyroidism and the course of Graves’ ophthalmopathy // N Engl J Med. 1998. 338:73–8.
5. Boger M.S., Perrier N.D. Advantages and disadvantages of surgical therapy and optimal extent of thyroidectomy for the treatment of hyperthyroidism // Surg Clin N Am. 2004. 84:849–74.
6. Chen C.R., Pichurin P., Nagayama Y., Latrofa F., Rapoport B., Mclachlam S.M. The thyrotropin receptor autoantigen in Graves’ disease is the culprit as well as the victim // J Clin Invest. 2003. 111:1897–904.
7. Oriazzi J. Management of Graves’ hyperthyroidism // Endocrin Metab Clin N Am. 1987. 16:365–88.
8. Galkin E.V., Grakov B.S., Protopopov A.V. First clinical experience of radioendo-vascular functional thyroidectomy in the treatment of diffuse toxic goiter // Vestn Rentgenol Radiol. 1994. 3:29–35.
9. Piantanida E. Preoperative management in patients with Graves’ disease // Gland surgery. 2017. Vol. 6. P.476-481.
10. Pisanu A., Porceddu G., Podda M. et al. Systematic review with meta-analysis of studies comparing intraoperative neuromonitoring of recurrent laryngeal nerves versus visualization alone during thyroidectomy // J Surg Res. 2014. Vol. 188. P.152- 161.
References: [1-2]
1. Ajmagambetov M.Zh., Omarov N.B., Masalimov E.O., Auzhanov D.B. i dr. Nash opyt lecheniya diffuzno-toksicheskogo i uzlovogo zoba [Our experience in the treatment of diffuse toxic and nodular goiter]. Nauka Rossii: celi i zadachi [Science of Russia: goals and objectives]. 2020. №3, pp.54-56. [in Russian]
2. Esbergenova M.Zh., Zamanbekova Zh.K., Uvataeva Zh.S. i dr. Sostojanie shhitovidnoj zhelezy u naselenija rajonov, prilegajushhih k byvshemu Semipalatinskomu ispytatel'nomu jadernomu poligonu [The state of the thyroid gland in the population of areas adjacent to the former Semipalatinsk nuclear test site]. Nauka i Zdravoohranenie [Science & Healthcare]. 2014. № 5, pp. 28-32. [in Russian].
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Bibliography link
Aimagambetov M.J., Omarov N.B., Mukash Ye.A., Dyussupov A.A., Bulegenov T.А., Auenov M.A., Abdrakhmanov S.T., Zharikov A.N., Korganbaeva G.A., Orynbasarov. Sh.O. Ways to improve the results of surgical treatment of diffuse toxic goiter // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 4, pp. 77-85. doi 10.34689/SH.2023.25.4.009Related publications:
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