[Present strategies in the diagnosis and treatment of thyroid diseases].
OBJECTIVE
Selective and critical presentation of the present exploring methods concerning surgical thyroid diseases and accomplishing a pre-surgical diagnosis as accurate as possible. Depending of the diagnosis--choosing the most appropriate surgical strategy according to the newest concepts in thyroid pathology.


METHODS
Clinical-statistic study, carried out retrospectively over 1,108 patients having various surgical thyroid maladies hospitalized in 1980-1999 period. There have been operated 1,058 cases. Demographic structure as regards sex, F/M was 9.07/0.93 for goiters, whereas for thyroid cancer it was 3/1.


RESULTS
Nodular goiters are the most frequent (77.31%), with a pathology benign majority (91.30%). The fundamental problem is the pre-surgical establish malign lesions that require a complex therapeutic protocol comparing to benign nodules. Benign lesions 91.30%, carcinomas 5.48%, others 3.21%. All types of thyroidectomies have been made: T.ST 69.37%, T.T for benign and malign lesions 7.65% and other procedures. Thyroid specific morbidity is 4.25%, whereas unspecific is 8.69%. The 0.08% mortality (1 case), virtually null, place the result between the best of the kind.


CONCLUSIONS
Pre-surgical diagnosis, as accurate as possible, based on the clinic exam using the vacuum punction with a fine needle, finally confirmed by the paraffin exam, provided the choice of an optimal surgical strategy, followed by an appropriate post-surgical protocol. Total thyroidectomy is the preferred procedure is most of the thyroid cancer forms and in benign diseases is highly recommended (multi-nodular goiters, hyperthyroid, Basedow disease, cancer).
Ghelase
F
F
Clinica de Chirurgie I, Craiova.
Georgescu
I
I
Ghelase
S
S
Mărgăritescu
D
D
Mercuţ
D
D
Dăbuleanu
P
P
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D003196:Computer Graphics; D005260:Female; D006044:Goiter, Nodular / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D013959:Thyroid Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery