Shabhay Ahmed Ali, Massaga Fabian Anaclet, Mwami Amri Salim, Ngwira Jonathan Joseph, Ndyamkama Domician Sospeter, Shabhay Zarina Ali
Military Hospital Mwanza, P. O Box 589, Mwanza, Tanzania.
Bugando Medical Center, P. O Box 1370, Mwanza, Tanzania.
Int J Surg Case Rep. 2025 Feb;127:110931. doi: 10.1016/j.ijscr.2025.110931. Epub 2025 Jan 27.
Surgical management of huge multi-nodular goiters present clinical and surgical management dilemma among practicing surgeons. Thyroidectomies pose huge risk potential when performed by relatively inexperienced and junior operators.
We present a case of a 40-year-old lady who had presented at our center with a ten-year history of painless anterior neck swelling. She was diagnosed with a multinodular goiter and underwent total thyroidectomy.
Success of thyroid surgery depends upon operators' skill, training, experience, specialty and "thyroid volume surgery" index. Huge thyroid gland surgeries even to competent performers presents with challenges. The choice of type of thyroidectomy is still a dilemma among practicing surgeons. The employment of total thyroidectomy presents with risks of recurrent laryngeal nerve injury and parathyroid glands injury due to the nature of the radical dissection. However, it offers the advantage of complete resection of the diseased gland and alienates the chances of recurrence.
It is the authors' opinion that total thyroidectomy for huge multi-nodular goiters is a safe procedure when performed by trained skilled surgeons and should be the standard for the management of multinodular goiters.
巨大结节性甲状腺肿的外科治疗给外科医生在临床和手术管理方面带来了两难困境。由经验相对不足的初级手术医生进行甲状腺切除术时存在巨大的潜在风险。
我们报告一例40岁女性患者，她因无痛性颈前肿胀10年就诊于我院。她被诊断为结节性甲状腺肿并接受了全甲状腺切除术。
甲状腺手术的成功取决于手术医生的技能、培训、经验、专业以及“甲状腺体积手术”指数。即使对于经验丰富的手术医生，巨大甲状腺手术也面临挑战。在执业外科医生中，甲状腺切除术的类型选择仍然是一个难题。由于根治性解剖的性质，全甲状腺切除术存在喉返神经损伤和甲状旁腺损伤的风险。然而，它具有完全切除病变腺体的优势，并消除了复发的可能性。
作者认为，对于巨大结节性甲状腺肿，由训练有素、技术熟练的外科医生进行全甲状腺切除术是一种安全的手术方式，应成为结节性甲状腺肿治疗的标准方法。
