PROBABILITY OF CANCER DETECTION DURING REPEATED OPERATIONS IN PATIENTS WITH BENIGN THYROID DISEASES


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Abstract

Introduction. Suspected malignant growth in patients with recurrent goiter is one of the main causes of repeated operations. Focuses of carcinoma can be detected in patients operated on for multinodular goiter with compression of the organs of the neck, recurrent diffuse toxic goiter. Objective of investigation is to assess the risk of a malignant lesion of the thyroid remnant in patients with recurrent goiter, to justify the surgical tactics in this group of patients. Material and methods. In the St. Petersburg Center of Endocrine Surgery and Oncology 28138 patients with various thyroid diseases were operated on for the period from 1973 till 2016. Results. In a retrospective analysis of the group consisting of 1106 patients with recurrent goiter, a new thyroid disease was detected in 156 (14.1%) cases. Thyroid cancer in thyroid remnant was detected in 57 (36.5%) cases or 5.2% of all the patients with recurrent goiter. The work describes the risk of malignant lesion of the thyroid remnant in patients with recurrent goiter and surgical tactics in this group of patients. Conclusion. Cancer of the thyroid gland, as a new disease of the thyroid remnant, in patients previously operated on for benign thyroid pathology, is found in 5.2% of observations. The possibilities of fine-needle aspiration biopsy in this group are reduced. Active surgical tactics in cases of multinodular transformation of the thyroid remnant is justified. The operation of choice is reresection up to thyroidectomy. Careful intraoperative study of removed tissue and close cooperation with the morphological service helps to reduce the number of diagnostic and tactical errors in patients with both recurrent and ordinary multi-node goiter.

About the authors

A F Romanchishen

Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice

194100, Litovskaya Str., 2, St. Petersburg, Russia

A V Gostimsky

Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice

194100, Litovskaya Str., 2, St. Petersburg, Russia

A L Akinchev

Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice

194100, Litovskaya Str., 2, St. Petersburg, Russia

I V Karpatsky

Federal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” Ministry of Healthcare of the Russian Federation, Department of Hospital Surgery (1), Department of General Medical Practice

194100, Litovskaya Str., 2, St. Petersburg, Russia

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Copyright (c) 2019 Romanchishen A.F., Gostimsky A.V., Akinchev A.L., Karpatsky I.V.

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