Department of Surgery for Breast and Thyroid, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
Int J Med Sci. 2012;9(9):778-85. doi: 10.7150/ijms.5129. Epub 2012 Oct 24.
To summarize the experience in the peri-operative treatment of giant nodular goiter.
A total of 123 patients with giant nodular goiter sized 6~20 cm were admitted into our hospital from 1990 to 2011 and the clinical data were retrospectively analyzed. These patients underwent total or subtotal thyroidectomy.
All patients underwent surgical intervention. Unilateral subtotal thyroidectomy was performed in 40 patients, unilateral total thyroidectomy in 1 patient, bilateral subtotal thyroidectomy in 79 patients, and unilateral total thyroidectomy, removal of entire isthmus and contralateral subtotal thyroidectomy in 3 patients. Nodular goiter was pathologically proven post-operatively. No short-term complications such as dyspnea or thyroid storm were found postoperatively. Post-operative follow up was done for 9 months to 6 years and no recurrence was observed.
Comprehensive pre-operative preparation, pre-operative evaluation, complete exposure of the operative field, meticulous operation, effective control and prevention of hemorrhage and prevention against damage to superior and recurrent laryngeal nerves are crucial for the successful surgical intervention of giant nodular goiter.
总结巨大结节性甲状腺肿围手术期治疗经验。
回顾性分析 1990 年至 2011 年我院收治的 123 例 6~20cm 巨大结节性甲状腺肿患者的临床资料。所有患者均行甲状腺全或次全切除术。
所有患者均接受了手术干预。40 例行单侧次全切除术，1 例行单侧全切除术，79 例行双侧次全切除术，3 例行单侧全切除、峡部切除及对侧次全切除术。术后病理证实为结节性甲状腺肿。术后无呼吸困难、甲状腺危象等短期并发症。术后随访 9 个月至 6 年，无复发。
充分的术前准备、术前评估、充分显露术野、精细操作、有效控制和预防出血、预防上、喉返神经损伤，是巨大结节性甲状腺肿手术成功的关键。
