new approach for thyroidectomy [isthmus first]: a preliminary study

Doing surgery for a huge goiter is always time consuming with difficulty to deliver goiter to the operating field which might increase morbidity. Therefore, this study was carried out to demonstrate a new technique in dealing with huge goiter. A total of 287patients with huge goiter admitted to Al-Ramadi general hospital, Al-Anbar governorate, during Feb. 1993 to Dec. 2002 were included in the study. Two types of surgical techniques were differentiated, the conventional one versus isthmus first. Out of the total patients 133 [46.3%] were underwent conventional thyroidectomy and 154 [53.7%] were underwent isthmus first technique. A significant reduction in operation time in isthmus first than in the conventional one was observed. Significant reduction in postoperative bleeding, temporarily Hypoparathyroidism, and external laryngeal nerve injury was noticed. Simple multinodular goiter, toxic goiter, neoplastic goiter and Hashimato's thyroiditis were the histopathological diagnosis of goiter underwent thyroidectomy in both surgical techniques. Isthmus first provides less operating time and surgical invasiveness and easily handling goiter than the conventional one

Retroperitoneal tumors: types and presentations

The retroperitoneal tumors is usually confined to lesions arising from tissues [muscles, fat, lymph nodes, nerves, and, developmental remnant] of this compartment but excluding origin from the retroperitoneal organs [panaceas, kidney, ureters and adrenals]. The aim of the study is to focus a light on the types of retroperitoneal tumors, ways of the investigations and the presentations. A prospective review study of 25 patients with retroperitoneal tumors has been collected in the Medical City Teaching Hospitals During the period between Jan 2001 to Mar 2004. The data included age, gender, risks factors, clinical presentations, diagnostic modalities and results ofhistopathology. 14 males [56%] and 11 females [44%_ patients. The highest incidence of patients were in the [51-60 years] age group [10/25, 40%]. The most common presenting feature was abdominal mass [20/25, 80%]. u/s and CT scan were the most reliable investigations in the diagnosis. The most common tumors were sarcomas [15/25, 60%] and lymphomas [5/25, 20%]. Although retroperitoneal neoplasms account for 0.1 - 0.2% of all malignancies [s], it seems that from our findings most of the tumors were malignant, where the sarcoma represents the common tumor among them, the presentations and the diagnostic modalities especially u/s and CT have a similarity with most of the studies reviewed