[Changing trends in the treatment of nodular thyroid disease--own experience].
If the first surgical intervention for benign euthyroid goiter diseased portion is not totally removed one cannot be certain of the long-term behaviour of the remaining tissue. In one third of these patients there may be a recurrence with new nodules developing, functional disorders or even carcinoma may appear in the remnants. Hormonal activity of the removed tissue can be completely substituted for by levothyroxine. That is why some experienced specialists recommend primarily radical surgery even in benign disease, based on their experience with large number of patients. The authors started performing radical excisions in the past three years. A total of 477 operations were performed between 1st January 2000 and 31st December 2002, 45% were radical: lobectomy, near-total thyroidectomy and bilateral lobectomy. Surgery was carried out according to the standardized morphologically adjusted technique (SMART). Results of these operations are compared to conventional procedures performed in the same period. Complication rate was low with no mortality. There was no significant difference between early results of the two groups. About 2% rate of permanent recurrent laryngeal nerve injury a 3% rate of postoperative tetany (hypocalcaemia) in both groups is acceptable. Based on their initial experiences the authors recommend the radical surgical technique for the experienced surgeons.
Berecz
János
J
Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Sebészeti Osztály, Miskolc.
Bende
Sándor
S
Papp
László
L
Szilágyi
Szabolcs
S
D002277:Carcinoma / Q000601:surgery; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D006980:Hyperthyroidism / Q000601:surgery; D006996:Hypocalcemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome