Abstract
The study developed the system of therapeutic and prophylactic methods in patients with recurrent postoperative goiter. These patients (103) have been accepted and registered in the medical records since 2007. Only 48 patients underwent recurrent operation. The subtotal resection of the thyroid gland was performed on 20 patients and thyroidectomy was carried out in 28 patients. The perioperative visualization of recurrent laryngeal nerves was made in 58,3% cases. Postoperative period was complicated by unilateral recurrent nerve trauma in one patient and transient hypoparathyroidism was noted in two patients. The recurrent operative interventions must be performed in specialized centers and it should be extremely radical operation with visualization of recurrent laryngeal nerves.
Highlights
The study developed the system of therapeutic and prophylactic methods in patients with recurrent postoperative goiter
The subtotal resection of the thyroid gland was performed on 20 patients and thyroidectomy was carried out in 28 patients
The perioperative visualization of recurrent laryngeal nerves was made in 58,3% cases
Summary
Цель исследования — разработка комплекса лечебных и профилактических мероприятий у больных с рецидивным послеоперационным зобом. По настоящее время на базе центра принято и поставлено на диспансерный учет 103 пациента с рецидивным послеоперационным зобом, из которых прооперировано 48 пациентов. Субтотальная резекция щитовидной железы выполнена у 20 пациентов, тиреоидэктомия — у 28 пациентов. Интраоперационная визуализация возвратных гортанных нервов осуществлена в 58,3% случаев. Послеоперационный период осложнился односторонней травмой возвратного нерва у одного больного и транзиторным гипопаратиреозом — у двух. Повторные хирургические вмешательства должны проводиться в специализированных центрах и носить предельно радикальный характер с визуализацией возвратных гортанных нервов. Ключевые слова: рецидивный послеоперационный зоб, тиреоидэктомия, возвратный гортанный нерв.
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