Total thyroidectomy in treatment of non-malignant goiter: is it worthwhile?

Total thyroidectomy is increasingly being accepted as a treatment of choice for differentiated thyroid cancer. However, because of presumed increased morbidity associated with this procedure, it is still not considered a viable option for management of benign thyroid disorders. To assess the safety and efficacy of total thyroidectomy for management of benign thyroid disorders, we analyzed our data from 100 total thyroidectomies performed for benign thyroid disorders. Demographic details, biochemical findings, indications for operation, specimen weight, and complications were noted. Among these patients, 35 had a toxic goiter and 65 had a non toxic goiter. The mean duration of goiters was 3.8 +/- 3.06 years [3 - 8 years], and the mean weight of the specimens was 85 gm +/- 180 gm. The incidence of permanent hypothyroidism and permanent recurrent laryngeal nerve plasy were 1% in both. According to this study, we can conclude that: total thyroidectomy should be considered as the treatment of choice for multinodular goiter and Graves' disease in a setting of palpable nodule[s] or ophthalmopathy [or both] because reoperation for recurrent goiter in such a setting would be hazardous with distressing complications

Special tactics in repair of epigastric hernia

This study included 30 patients presented with epigastric hernias of different sizes. Careful clinical examination and preoperative investigations were done to evaluate the general conditions of the patients and to treat any correctable medical disease. After assuring that there was no contraindication to surgery, the elective surgically correction of the hernia was done by a special technique in all patients using three-layer repair [vest-over pants repair, gel foam packing and prolene mesh [hernioplasty]. A follow up of the patients was done for one year. The results were very satisfactory with no recurrence

Human leucocyte antigen [HLA] class one [A1, B7] and class two [DR-11] are new factors affecting the incidence of colonic carcinoma

The problem of colonic carcinoma is still a dilemma regarding, diagnostic and therapeutic strategy. Many factors have been found to affect the incidence of this type of cancer such as age, sex, diet and previous abdominal surgery. A survey study revealed that in normal [control] population HLA-A1 was positive in about 50%. HLA-B7 was positive in about 8% and HLA-DR11 was positive in about 40%. The aim of this study was to find a relation between the above-mentioned types of HLA and the increased or decreased risk of incidence of colonic carcinoma. Thirty patients were diagnosed after using: careful history taking, clinical examination, laboratory, and radiological investigations. Finally colonoscopy and biopsy were done. Detection of [HLA- A1. B7] was done serologically using Sigma USA. Detection of [HLA-DR 11] was done using lymphobeads method [Biotest Great Britain [UK] Itd]. HLA-A1 was found to be positive in eight patients while HLA-B7 was positive in seven patients, and HLA-DR 11 was positive in ten patients. HLA-A1 positive results were associated with increased risk of incidence of colonic carcinoma by 45%, while HLA-B7 positive results were associated with increased risk of incidence by 233% and presence of HLA-DR11 positive results were associated with decreased risk incidence by 80%. So we can consider the above-mentioned HLA types as new factors affecting the incidence of colonic carcinoma