Challenges for huge goiter surgery | ||
| The Egyptian Journal of Surgery | ||
| Volume 38, Issue 2, April 2019 PDF (2.21 M) | ||
| DOI: 10.4103/ejs.ejs_212_18 | ||
| Authors | ||
| Ahmed Abbas; Mostafa Sakkary; Ahmed Naser | ||
| Abstract | ||
| Objective To highlight the technical challenges and perioperative management of huge goiter guided by ultrasound scanning and, in some cases, computed tomography (CT) scan. Patients and methods Twenty-seven patients presented with large thyroid masses, whether primary or recurrent, and were studied and investigated retrospectively. Triple assessment was done for all patients in the form of history and physical examination, imaging studies, and fine-needle aspiration cytology. Intraoperative technical challenges and postoperative complications were focused on. Every patient has been scanned primarily by ultrasound examination of the neck followed by CT scan if ultrasound was unable to answer all the questions asked and requested by the treating physicians. Results All patients underwent surgical intervention in the form of total or completion total thyroidectomy with or without central lymph node dissection. Transient hypocalcemia was seen in six (22.22%) patients. (Three 11.11 %) patients developed postoperative temporary hoarseness of voice. No major intraoperative or postoperative bleeding was encountered, and no evidence of recurrence was detected during the follow-up period from 6 months to 3 years. Ultrasound was considered enough imaging modality in seven out of the 27 patients, whereas CT scan had to be done in the remaining 20 patients. Conclusion Thyroidectomy for huge goiter is a technical challenge but remains the best option for effective and definitive management. Diagnostic radiology is considered an essential part in the preoperative assessment of these patients. Comprehensive perioperative management and team work are crucial for successful outcomes. | ||
| Keywords | ||
| huge goiter; imaging; Surgery | ||
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