[Nodular thyreopathies. Results of 1300 operations].
To evaluate the results of surgery for nodular thyreopathies, 1300 cases operated on from January 1974 to December 1987 were reviewed. 842 patients (64.7%) were female; the average age, 41 +/- 2.4 year. Thyroid pathology was represented by solitary nodule in 643 cases (49.4%); multinodular goitre in 559 cases (43.0%) (377 euthyroid and 182 hyperthyroid patients); retrosternal in 78 cases (5.9%); recurrent goitre in 20 cases (1.5%). The patients underwent total thyroidectomy (525 cases); sub-total thyroidectomy (132 cases); total lobectomy (643 cases). Post-operative follow-up (clinical exam; T3, T4, tsh analysis); was performed at 3, 6, 12 and 24 months. The overall mortality rate was 0.13 percent (two deaths, respectively after total-0.1% - and sub-total thyroidectomy-0.7%). Immediate post-operative complications were: recurrent palsy (9 cases, 0.6%); acute respiratory failure (2 cases, 0.7%); hypoparathyroidism (3 cases, 0.2%). Late sequelae (1-3 year) were recurrent nerve palsy in 7 patients (0.5%); hypoparathyroidism in one case (0.07%). 46 patients which underwent sub-total thyroidectomy were hypothyroid to T3, T4, TSH analysis and required thyroxine support treatment. New concepts on the pathogenesis of multinodular goitre (growth autonomy of goitre human tissue; failure of thyreosuppressive therapy to prevent relapses after sub-total thyroidectomy) and the results of this review of 1300 interventions seems confirm the indication to total thyroidectomy in the treatment of both euthyroid and toxic multinodular goitre.
Clinique Chirurgicale, Université de Messine, Italie.
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Carditello
D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D003560:Cysts / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013959:Thyroid Diseases / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D013972:Thyrotropin / Q000097:blood
D013972:Thyrotropin
Thyréopathies nodulaires. Les résultats de 1300 interventions.