Evaluation of long-term results of surgical treatment of toxic goiter

Abstract

Purpose – to improve the methodology for assessing the long-term results of surgical treatment of toxic goiter. Materials and methods. Studies conducted in 150 surgically treated patients with moderate (48) and severe (102) toxic goiter. We developed methodology of long-term results assessment with gradations of good, satisfactory, unsatisfactory and ineffective treatment. One year after surgery in comparison with baseline data we studied the changes in general condition, structural and functional disorders of the heart muscle, severity and functional class of heart failure, heart rhythm disorders. Results and discussion. In patients with hyperthyroidism of moderate severity good result was found in 26 (54.2%) cases, satisfactory – in 21 (43.7%) patients and unsatisfactory – in 1 (2.1%). In patients with severe thyrotoxicosis remote outcome was assessed as good in 9 (8.8%), satisfactory – in 36 (35.3%), unsatisfactory – in 33 (32.4%) cases. Ineffective surgical treatment was found in 24 (23.5%) patients. We established that long-term results depend on the severity and duration of hyperthyroidism. Unsatisfactory results and ineffective surgical treatment were found in patients with severe rhythm disorders, structural and functional changes in the heart muscle and II or III functional class of heart failure. Conclusions. Long-term results of surgical treatment of toxic goiter determined by the severity of structural changes in the heart muscle and cardiac functional disorders. Along with the growth of the severity and duration of hyperthyroidism increases the number of cardiac rhythm disorders: from supraventricular beats to persistent / permanent atrial fibrillation. In cases of severe thyrotoxicosis, the need of surgical treatment should be considered as soon as possible, at least before development of severe rhythm disorders and cardiac structural and functional changes in the heart muscle.