ABSTRACT
The charts of 64 patients, 54 female, aged between 15 and 57 years old, operated between 1985 and 1995 were analyzed. The indication for surgical treatment was failure of medical treatment in 59 patients and a big goiter causing mechanical compression in 3 patients. A subtotal thyroidectomy was done after an abbreviated surgical preparation. The mean weight of the resected glands was 65.9 g. Four patients had transient hypocalcemia and 4 had surgical wound seromas. After a mean follow up of 31 months, 77 percent of patients remain euthyroid, hyperthyroidism relapsed in 13.1 percent and 10 percent became hypothyroid. Surgical treatment of hyperthyroid goiter is safe but the percentage of hyperfunction relapse is high
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Goiter/surgery , Hyperthyroidism/surgery , Postoperative Complications/epidemiology , Thyroidectomy , Thyroid Function Tests/statistics & numerical dataABSTRACT
Medullary carcinoma of the thyroid is an infrequent type of thyroid tumor. To retrospectively study all cases of MCT diagnosed at a regional hospital. The charts and pathological studies of eight patients with MCT among 75 with thyroidal cancer were reviewed. Solitary nodules were the presenting gign in seven patients and cachexia in one. Five patients were subjected to total thyroidectomy, five to cervical lymph node dissection and 4 to complementary radiotherapy. Pathological diagnoses was made with the surgical piece in 7 patients and the aspiration cytology in 1. Five of the 8 patients are alive after 50 months of follow up as a mean, 1 patient with bone metastasis. The small sample size precludes conclusions on the prognosis and treatment of the disease
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Thyroid Neoplasms/epidemiology , Carcinoma, Medullary/epidemiology , Radiotherapy , Biopsy, Needle , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Retrospective StudiesSubject(s)
Humans , Male , Female , Adult , Thyroid Neoplasms/pathology , Carcinoma, Papillary/pathology , Goiter/pathology , Hyperthyroidism/pathologyABSTRACT
La cirugía en el paciente diabético conlleva un mayor riesgo de morbimortalidad en todo el período que rodea al acto quirúrgico, que el que presentan los no diabéticos sometidos a igual estrés. Hoy día, sin embargo, con el conocimiento que tenemos de la enfermedad diabética, es posible revertir en forma significativa esta situación con una adecuada valoración preoperatoria de su condición diabética y con un correcto manejo metabólico e hidroelectrolítico de todo el período perioperatorio. La evaluación preoperatoria debe estar orientada a la búsqueda de complicaciones crónicas de la enfermedad, en especial neuropatía, nefropatía y alteraciones cardiovasculares, las cuales le confieren a estos enfermos un adicional riesgo vital. El control óptimo de los niveles de glucosa sanguínea en el período preoperatorio, permite enfrentar el acto quirúrgico y el postoperatorio inmediato sin el riesgo de una hipoglicemia o de una quetoacidosis y evita, en un número importante de casos, la prolongación innecesaria de la hospitalización. El manejo metabólico adecuado de estos enfermos requiere de un trabajo multidisciplinario, coordinado y basado en normas técnicas simples