RESUMO
The authors analyse the results of surgical treatment of 254 children with various diseases of the thyroid and follow-up periods of 12 months to 20 years. They recommend the optimal time for and the volume of the operative intervention according to the form of the goiter and the children's age. The causes of the development of postoperative hypothyroidism and a recurrence of thyroid diseases in childhood are discussed and the measures for their prevention are indicated.
Assuntos
Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Recidiva , Fatores de Tempo , Resultado do TratamentoRESUMO
The results of surgical treatment of various forms of diseases of the thyroid gland in 254 children are analysed in follow-up periods of 12 months to 20 years. Functional compensation of the thyroid occurred in all patients with nodular forms of goiter who were subjected to operation which did not exceed hemithyroidectomy in volume. The analysis showed that operative treatment of children with the diffuse toxic form of goiter attended by the autoimmune component lead to hypothyroidism in 76.6% of patients, whatever the activity of the thyroid tissue, and a recurrence developed in 11.7% of those who were operated on. In children without the autoimmune component postoperative hypothyroidism was found in 48.6% of those examined, a recurrence was found in 3.2% of cases. The indications for operative treatment are specified, measures for the prevention of postoperative complications are listed.
Assuntos
Bócio Nodular/cirurgia , Doença de Graves/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Adolescente , Criança , Pré-Escolar , Doença Crônica , Feminino , Seguimentos , Bócio Nodular/epidemiologia , Bócio Nodular/fisiopatologia , Doença de Graves/epidemiologia , Doença de Graves/fisiopatologia , Humanos , Masculino , Glândula Tireoide/fisiopatologia , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/fisiopatologia , TireoidectomiaRESUMO
The authors discuss the effect of immunological shifts in 102 children with hyperthyroidism goiter on the outcomes of surgical treatment. Deviations in the immune status of children suffering from this disease were found to have an unfavourable effect on the outcome of surgical treatment. Recurrences were more frequent and postoperative hypothyroidism developed. The initial condition of the immune status helps in prognosing the further course of the pathological process and guides the therapeutic correction in the pre- and postoperative periods.
