Some aspects of prevention of postoperative relapse in patients with nodular forms of goiter

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N.P. Tkachuk
V.V. Bilookyi
Ya.V. Gyrla


Background. Annual prevalence of nodular forms of goiter leads to an increase in the number of surgeries, and therefore, to an increase of postoperative complications. According to different authors, from 3 to 80 % of patients suffering from nodular forms of goiter are operated in case of relapse. This wide range can be caused by the lack of a unified monitoring system, prediction and prevention of relapses during postoperative period. The purpose of the study: to assess the prognostic possibilities of the developed scale to predict the risk of nodular goiter relapse. Materials and methods. 100 case histories of patients suffering from nodular forms of goiter was the material for retrospective study. The main group included 40 persons operated for the second time on goiter relapse; comparison group included 60 persons without relapse. Eighty patients with different forms of goiter became a clinical material for prospective study. The main group consisted of 40 patients with nodular goiter. To choose the volume of surgery in this group, the relapse risk prognostic scale concerning nodular form of goiter was used. The comparison group included 40 patients who underwent surgery without the use of the scale. Results. The retrospective analysis conducted has drawn our attention to the fact that in 80 % of patients with relapse of goiter, the first surgery was sparing, while in 90 % of them, radical surgical would be reasonable. Hemi- or thyroidectomy were performed in 60 % of patients without relapses, while only 45 % of them required such surgery. Prospective study during observation has found that two patients from the first group and 12 patients from the second group had relapses of the disease. Conclusions. Therefore, the relapse risk prognostic scale concerning nodular forms of goiter is an effective method to prevent their relapses.

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Tkachuk, N., V. Bilookyi, and Y. Gyrla. “Some Aspects of Prevention of Postoperative Relapse in Patients With Nodular Forms of Goiter”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 13, no. 8, Dec. 2017, pp. 536-40, doi:10.22141/2224-0721.13.8.2017.119266.
Clinical Thyroidology


Giorgio G, Rocco B, Giuseppe L, et al. Temporal Changes in Thyroid Nodule Volume: Lack of Effect on Paranodular Thyroid Tissue Volume. Thyroid. 2017;27(11):1378-1384. doi: 10.1089/thy.2017.0201.

Durante C, Costante G, Lucisano G et al.The natural history of benign thyroid nodules. JAMA. 2015;313(9):926-35. doi: 10.1001/jama.2015.0956.

Baloch ZW, LiVolsi VA. Current role and value of fine-needle aspiration in nodular goiter. Best Pract Res Clin Endocrinol Metab. 2014 Aug;28(4):531-44. doi: 10.1016/j.beem.2014.01.010.

Jiang J, Huang L, Zhang H, et al. Contrast-enhanced sonography of thyroid nodules. Journal of Clinical Ultrasound. 2015;43(3):153-56. doi: 10.1002/jcu.22240.

Dakubo JC, Naaeder SB, Tettey Y, Gyasi RK. Pathology and the Surgical Management of Goitre in an Endemic Area Initiating Supplementary Iodine Nutrition. West Afr J Med. 2013 Jan-Mar;32(1):45-51. PMID: 23613294.

Chen AY, Bernet VJ, Carty SE, et al. American Thyroid Association statement on optimal surgical management of goiter. Thyroid. 2014 Feb;24(2):181-9. doi: 10.1089/thy.2013.0291.

Tsurkan AY. Modern approaches to treatment of recurrent goiter. Vestnik novykh meditsinskikh tekhnologii. 2013;20(2):254-7. (in Russian)

Tarashchenko YM, Bolhov MY, Ivanova OM, Herasymenko VB, Boiko ZN. Long-term results of surgical treatment for benign focal thyroid lesions. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2015;67:133-9. (in Ukrainian).

Attaallah W, Erel S, Canturk NZ, et al. Is hemithyroidectomy a rational management for benign nodular goitre? A Multicentre Retrospective Single Group Study. Neth J Med. 2015 Jan;73(1):17-22. PMID: 26219937.

Rayes N, Seehofer D, Neuhaus P. The surgical treatment of bilateral benign nodular goiter. Balancing invasiveness with complications. Dtsch Arztebl Int. 2014 Mar 7;111(10):171-8. doi: 10.3238/arztebl.2014.0171.

Bauer PS, Murray S, Clark N, Pontes DS, Sippel RS, Chen H. Unilateral thyreoidectomy for the treatment of benign multinodular goiter. J Surg Res. 2013 Sep;184(1):514-8. doi: 10.1016/j.jss.2013.04.045.

Kuroda K, Uchida T, Nagai S, et al. Elevated serum thyroid-stimulating hormone is associated with decreased anti-Müllerian hormone in infertile women of reproductive age. J Assist Reprod Genet. 2015 Feb;32(2):243-7. doi: 10.1007/s10815-014-0397-7.

Afolabi AO, Ayandipo OO, Afuwape OO, Ogundoyin OA. A fifteen year experience of total thyroidectomy for the management of simple multinodular goitres in a low medium income country. S Afr J Surg. 2016 Nov;54(4):40-45. PMID: 28272855.

Karthikeyan P, Muthu S. Retrospective Analysis of Thyroidectomy Cases in a Tertiary Care Hospital. International journal of scientific study. 2017;5(1):50-52. doi: 10.17354/ijss/2017/153.

Cappellani A, Zanghì A, Cardì F, et al. Total Thyroidectomy: the first, the best. The recurrent goiter issue. Clin Ter. 2017 May-Jun;168(3):e194-e198. doi: 10.7417/T.2017.2005.

Sewefy AM, Tohamy A, Esmael TM, Atyia AM. Intra-capsular total thyroid enucleation versus total thyroidectomy in treatment of benign multinodular goiter. A prospective randomized controlled clinical trial. Int J Surg. 2017 Sep;45:29-34. doi: 10.1016/j.ijsu.2017.07.074.

Mauriello C, Marte G, Canfora A, et al. Bilateral benign multinodular goiter: What is the adequate surgical therapy? A review of literature. Int J Surg. 2016 Apr;28 Suppl 1:S7-12. doi: 10.1016/j.ijsu.2015.12.041.

Wienhold R, Scholz M, Adler JR, Günster C, Paschke R. The management of thyroid nodules: a retrospective analysis of health insurance data. Dtsch Arztebl Int. 2013 Dec 6;110(49):827-34. doi: 10.3238/arztebl.2013.0827.

Sorensen JR, Watt T, Cramon P, et al. Quality of life after thyroidectomy in patients with nontoxic nodular goiter: A prospective cohort study. Head Neck. 2017 Nov;39(11):2232-2240. doi: 10.1002/hed.24886.

Anbalagan P, Manikannan AS, Khan AMI. Study of post-operative complications of thyroid surgery. J Evolution Med Dent Sci. 2017;6(5):413-418. doi: 10.14260/Jemds/2017/92.

Raj MKMR, Akmal. Comparative study – outcome of subtotal thyroidectomy vs total thyroidectomy for multinodular goiter. J Evolution Med Dent Sci. 2016;5(46):2948-54. doi: 10.14260/jemds/2016/665.

Mauriello C, Marte G, Canfora A, et al. Bilateral benign multinodular goiter: What is the adequate surgical therapy? A review of literature. Int J Surg. 2016 Apr;28 Suppl 1:S7-12. doi: 10.1016/j.ijsu.2015.12.041.

Magri F, Zerbini F, Gaiti M, et al. Gender influences the clinical presentation and long-term outcome of graves disease. Endocr Pract. 2016;22(11):1336-1342. doi: 10.4158/EP161350.OR.

Vos XG, Endert E, Zwinderman AH, Tijssen JGP, Wiersinga WM. Predicting the Risk of Recurrence Before the Start of Antithyroid Drug Therapy in Patients With Graves' Hyperthyroidism. J Clin Endocrinol Metab. 2016 Apr;101(4):1381-9. doi: 10.1210/jc.2015-3644.

Struja T, Kaeslin M, Boesiger F, et al. External validation of the GREAT score to predict relapse risk in Graves’ disease: results from a multicenter, retrospective study with 741 patients. Eur J Endocrinol. 2017 Apr;176(4):413-419. doi: 10.1530/EJE-16-0986.

Struja T, Fehlberg H, Kutz A, et al. Can we predict relapse in Graves' disease? Results from a systematic review and meta-analysis. Eur J Endocrinol. 2017 Jan;176(1):87-97. doi: 10.1530/EJE-16-0725.