ABSTRACT
Objective To sum up the problems should be taking care in operations for huge goitres. Methods Retrospectively analyzed the clinical data of 295 cases of huge goitres was made. Results All of the 295 cases had some degree of compress, replacement and bend of trachea by the goitre comfirmed by X ray examination .Among the 295 cases,162(54.9%) had trachea constriction.51(17.3%) had obvious dyspnea. Retrosternal goitres was found in 21 cases.12 complicated with secondary hyperthyroidism. All the 295 cases underwent subtotal or total thyroidectomy. Postoperative pathological diagnosis: nodular goitres was diagnosed in all the 259 cases (100%),including 11 cases(3.7%) with malignancy, 12 cases( 4.1% ) with secondary hyperthyroidism,and 39(15.1%) with adenomas. Conclusions Operation of huge goitres should choice appropriate anaesthetic method.For the main vessels of thyroid, very high position of the upper pole of thyroid, retrosternal goitres, malignancy of goitres etc,appropriate operative measures shoudd be adopted to prevent introoperative massive bleeding and damage of recurrent laryngeal nerve. If the indications of tracheostomy presents,a tracheostomy must be done.
ABSTRACT
Objective To investigate the diagnosis and treatment of nodular goiter with thyroid carcinoma.Methods The clinical data of forty cases of nodular goiter with thyroid carcinoma admitted to our hospital from January 2005 to December 2007 were retrospectively analyzed.Results Among the 40 cases,only four cases were preoperatively diagnosed as nodular goiter with thyroid carcinoma.All cases received operation and the diagnosis were comfirmed by frozen section examination.Various modes of thyroidectomy were performed according to the pathological results,including four cases had unilateral total thyroidectomy,27 had unilateral total thyroidectomy combined with opposite subtotal thyroidectomy,one case had bilateral subtotal thyroidectomy,and eight cases of bilateral total thyroidectomy.Of all 40 cases,11 cases received unilateral cervical lymph node dissection.There were only three cases occurred convulsion or numbness,and no hoarseness occurred postoperatively.Compared to simple nodular goiter,the incidence of calcification in nodular goiter with thyroid carcinoma was significantly increased(P
ABSTRACT
Objective To investigate the relationship between nodular goiter and thyroid cancer and the causes of postoperative recurrence in patients with nodular goiter(NG) undergoing operative treatment. Methods The clinical date of 199 cases of NG were retrospectively analysed. Results Pathological examination revealed that 7 cases were accompanied by thyroid cancer including 2 micro-cancer, all the 7 cases were papillary carcinomas. The postoperative recurrent rate of NG was 11.5%(18 cases).Thyroid nodule reccurrence rate in patients received - operative thyroxin replacement therapy was significantly lower than that in patients not received thyroxin therapy( P