Oncological risk of recurrent goiter

  • Introduction. Diagnostic and treatment ofinnocent and malignantthyroid diseases remains actual problem for Endocrine  surgery and Oncology. Risk factors of thyroid diseases relapses includes: inadequate estimation of tumor character and choice of surgery volume during initial or previous operations; absent or lack of postoperative medications or other treatments. 

    Material. In the St. Petersburg Center of Endocrine Surgery and Oncology 28138 thyroid patients were operated on during the period from 1973 till 2016. In a retrospective analysis of the 1106 patients with recurrent goiter, a new thyroid disease was detected in 156 (14.1%) cases. Thyroid cancer in thyroid remnant was detected in 57 (36.5%) cases or 5.2% of the all patients with recurrent goiter. In the paper describes the risk of malignant lesion of the thyroid remnant in patients with recurrent goiter and consider surgical tactics in this group of. It was revealed that under the conditions of multimodal transformation of the thyroid remnant, changes in the topographic-anatomical relationships and scar tissue in the zone of the operation, the possibilities of fine needle aspiration biopsy was sharply reduced. Active surgical tactics in case of multinodular transformation of the thyroid remnant were justified.

    Conclusion. Level of surgical experience, regular using of perioperative ultrasound, fine needle estimations of thyroid nodules, intraoperative RLN monitoring procedure, intraoperative recurrent laryngeal nerves monitoring sharply increased accuracy of diagnosis and results of patients treatment. As the operation of choice should be considered resection of the thyroid gland to the extent of thyroidectomy. 

 

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