To the content
2 . 2023

Multidisciplinary approach to the treatment of patient with giant diffuse toxic goiter with neck compression syndrome

Abstract

Surgical tactics for giant thyroid nodules are widely covered in the literature. However, the treatment of such patients requires multidisciplinary approach. The team approach minimizes the risks of surgical treatment and ensures optimal recovery in the postoperative period. We present the clinical case of a 49-year-old female patient with a giant nodular toxic goiter. The article describes an integrated approach to the treatment of such patients, technical features and possible dangers when planning treatment in a multi-speciality hospital.

Keywords:thyroidectomy; giant goiter; goiter treatment; rehabilitation after thyroidectomy

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Glushkov P.S., Azimov R.Kh., Sozykin A.V., Nikitin P.A., Shubin D.I., Maruchak E.A., Kuzmina I.V., Pletner O.I., Husanov S.S., Karneev N.A., Levikin K.E., Shemyatovsky K.A., Shulutko A.M., Gorsky V.A. Multidisciplinary approach to the treatment of patient with giant diffuse toxic goiter with neck compression syndrome. Clinical and Experimental Surgery. Petrovsky Journal. 2023; 11 (2): 125–31. DOI: https://doi.org/10.33029/2308-1198-2023-11-2-125-131  (in Russian)

References

1.     Pesheva E.D., Morgunova T.B., Fadeev V.V. Modern approaches to the management of patients with Graves’ disease. Lechebnoe delo [Medical Care]. 2022; (1): 48–56. (in Russian)

2.     Troshina E.A., Sviridenko N.Yu., Vanushko V.E., Rumyantsev P.O., Fadeev V.V., Petunina N.A. Federal clinical guidelines for the diagnosis and treatment of toxic goiter. Problemy endokrinologii [Problems of Endocrinology]. 2014; 60 (6): 67–77. (in Russian)

3.     Grigor’ev E.G., Il’icheva E.A., Bersenev G.A., Makhutov V.N., Serebrennikova T.Yu. Clinical observation of toxic multinodular goiter with compression of the neck organs. Endokrinnaya khirurgiya [Endocrine Surgery]. 2020; (2): 10–5. (in Russian)

4.     Belokonev V.I., Kovaleva Z.V., Pushkin S.Yu., Galstyan N.E., Larina T.V. Indications for the scope of the operation and features of the thyroidectomy technique in patients with retrosternal goiter. Tavricheskiy mediko-biologicheskiy vestnik [Taurian Medical and Biological Bulletin]. 2020; 23 (2): 15–9. (in Russian)

5.     Kukhtenko Yu.V., Kosivtsov O.A., Ryaskov L.A., Abramyan E.I. Thyroidectomy in a patient with a giant multinodular non-toxic cervical-retrosternal goiter. Tikhookeanskiy meditsinskiy zhurnal [Pacific Medical Journal]. 2020; (1): 97–9. (in Russian)

6.     Shojaku H., Takakura H., Watanabe Y., Seto H. Pre-operative embolisation of the thyroid artery in a patient with a large papillary carcinoma of the thyroid. J Laryngol Otol. 2012; 126 (9): 955–9.

7.     Tartaglia F., Sorrenti S., Maturo A., Ulisse S. Selective embolization of the thyroid arteries (SETA): Ten years’ experience. Asian J Surg. 2019; 42 (8): 847–8.

8.     Sozykin A.V., Kichin V.V., Yurishchev A.Yu., Loboda A.A. Application of the method of endovascular embolization by a vascular occluder of the artery supplying juvenile angiofibroma and its effect on the level of surgical blood loss during endoscopic tumor resection. Mezhdunarodniy zhurnal interventsionnoy kardioangiologii [International Journal of Interventional Cardioangiology]. 2014; (39): 20–4. (in Russian)

9.     Dedecjus M., Tazbir J., Kaurzel Z., Strózyk G., Zygmunt A., Lewiński A., et al. Evaluation of selective embolization of thyroid arteries (SETA) as a perspective treatment in selected cases of toxic goiter. Thyroid Res. 2009; 2 (1): 1–7.

10. Thomusch O., Machens A., Sekulla C., Ukkat J., Lippert H., Gastinger I., et al. Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: Prospective multicenter study in Germany. World J Surg. 2000; 24: 1335–41.

11. Lee E., Lee K., Yu H.W., Kim S.J., Chai Y.J., Choi J.Y., et al. Comparison of recurrent laryngeal nerve identification time in the lower central triangle during thyroid surgery using neurophysiological mapping and monitoring. Medicina (Kaunas). 2021; 57 (8): 748.

12. Barczynski M., Konturek A., Cichon S. Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg. 2009; 96: 240–6.

13. Cirocchi R., Arezzo A., D’Andrea V., Abraha I., Popivanov G.I., Avenia N., et al. Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery. Cochrane Database Syst Rev. 2019; 1: CD012483.

14. Makar’in V.A., Uspenskaya A.A., Alekseev M.A., et al. Intraoperative neuromonitoring in surgical interventions on the thyroid and parathyroid glands: indications for performance, technique. Endokrinnaya khirurgiya [Endocrine Surgery]. 2016; (2): 5–16. (in Russian)

15. Schneider R., Randolph G.W., Dionigi G., et al. International Neural Monitoring Study Group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal. Laryngoscope. 2018; 128: 1–17.

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

Journals of «GEOTAR-Media»