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2015 | 87 | 7 | 331-335
Tytuł artykułu

Postoperative Acute Respiratory Failure In Patients Treated Surgically For Goiters

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
The aim of the study was to present a clinical picture, treatment and prognosis regarding patients who developed acute respiratory failure (ARF) while treated surgically for a goiter. Material and methods. A total of 3810 patients were treated for goiters between 2008 to 2013. Symptoms of postoperative ARF were recognized in 39 (1%) patients. Results. Symptoms of postoperative ARF were a postoperative hemorrhage in 31 (79.4%), lymphorrhagia in 1 (2.6%), bilateral paralysis of recurrent laryngeal nerves in 6 (15.4%) and acute circulatory – respiratory failure in 1 (2.6%). Postoperative hemorrhage appeared in 19 patients operated for nodular goiter, 4 with a retrosternal nodular goiter, 1x nontoxic recurrent retrosternal nodular goiter, 1x toxic recurrent retrosternal goiter nodular goiter, 2x Graves'goiter and 4x with malignant goiter. The cause of hemorrhage was parenchymal bleeding from the stumps and / or short neck muscles (29x), arterial bleeding (1x) and bleeding into the subcutaneous tissue (1x). Massive lymphorrhagia appeared as a result of damage to the thoracic duct after total thyroidectomy due to papillary thyroid carcinoma with cervical lymph node dissection on the left side. All patients who were diagnosed with bilateral paralysis of RLN, tracheostomy was performed. Of all 39 patients who underwent surgery two died – one in 6 days after surgery due to myocardial infarction, and another as a result of micropulmonary embolism and acute circulatory – respiratory failure in 18 hours after surgery. Conclusions. 1. The most frequent causes of acute respiratory failure in postoperative period are a hemorrhage from the operation site and bilateral paralysis of recurrent laryngeal nerves. 2. Acute postoperative respiratory failure is an indication for postoperative wound revision
Słowa kluczowe
Wydawca

Rocznik
Tom
87
Numer
7
Strony
331-335
Opis fizyczny
Daty
wydano
2015-07-01
otrzymano
2015-05-08
online
2015-09-07
Twórcy
  • Silesian Medical University in Katowice and Department of General and Endocrinal Surgery, Hospital No 2 in BytomKierownik: prof. dr hab., gregor6007@onet.eu
  • Silesian Medical University in Katowice and Department of General and Endocrinal Surgery, Hospital No 2 in BytomKierownik: prof. dr hab.
  • Silesian Medical University in Katowice and Department of General and Endocrinal Surgery, Hospital No 2 in BytomKierownik: prof. dr hab.
  • Silesian Medical University in Katowice and Department of General and Endocrinal Surgery, Hospital No 2 in BytomKierownik: prof. dr hab.
  • Silesian Medical University in Katowice and Department of General and Endocrinal Surgery, Hospital No 2 in BytomKierownik: prof. dr hab.
Bibliografia
  • 1. Testini M, Gurrado A, Lissidini G et al.: Emergency surgery for acute respiratory failure secondary to spontaneous thyroid hemorrhage. Int Surg 2008; 93: 158-62.
  • 2. Hor T, Lahiri SW: Bilateral thyroid hematomas after fine-needle aspiration causing acute airway obstruction. Thyroid 2008; 18: 567-69.
  • 3. Carditello A, Milone A, Stilo F et al.: Surgical treatment of acute respiratory failure caused by mediastinal goiter. Clinical experience and results. Chir Ital 2002; 54: 807-10.
  • 4. Lukieńczuk T, Rychlewski D, Bednarz W et al.: Acute respiratory failure in the course of thyroid disease. Przegl Lek 1999; 56: 134-38.
  • 5. Buła G, Paliga M, Koziołek H et al.: Acute respiratory failure in goitre patients qualified for operative treatment. Endokrynol Pol 2013; 64: 215-19.
  • 6. Hurtado-López LM, Zaldivar-Ramirez FR, Basurto Kuba E et al.: Causes for early reintervention after thyroidectomy. Med Sci Monit 2002; 8: CR247-50.
  • 7. Findlay JM, Mihai R: Complications of thyroid surgery. Br J Hosp Med (Lond). 2011; 72: M44-7.
  • 8. Lee HS, Lee BJ, Kim SW et al.: Patterns of Post-thyroidectomy Hemorrhage. Clin Exp Otorhinolaryngol 2009; 2: 72-77.
  • 9. Julien N, Mosnier I, Bozorg Grayeli A et al.: Intraoperative laryngeal nerve monitoring during thyroidectomy and parathyroidectomy: A prospective study. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129: 69-76.
  • 10. Rahman GA: Possible risk factors for respiratory complications after thyroidectomy: an observational study. Ear Nose Throat J 2009; 88: 890-92.
  • 11. Kennedy SA, Irvine RA, Westerberg BD et al.: Meta-analysis: prophylactic drainage and bleeding complications in thyroid surgery. J Otolaryngol Head Neck Surg 2008; 37: 768-73.
  • 12. White ML, Doherty GM, Gauger PG: Evidence-based surgical management of substernal goiter. World J Surg 2008 Jul; 32: 1285-300.
  • 13. Doran HE, Palazzo F: Ambulatory thyroid surgery: do the risks overcome the benefits? Presse Med 2014; 43: 291-96.
  • 14. Promberger R, Ott J, Kober F et al.: Risk factors for postoperative bleeding after thyroid surgery. Br J Surg 2012; 99: 373-79.
  • 15. Barczyński M, Konturek A, Cichoń S: Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg 2009; 96: 240-46.
  • 16. Bergenfelz A, Jansson S, Kristoffersson A et al.: Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbecks Arch Surg 2008; 393: 667-73.
  • 17. Friedel G, Kyriss T, Leitenberger A et al.: Longterm results after 110 tracheal resections. Ger Med Sci 2003; 18; 1: Doc10.
  • 18. Bradley PJ: Bleeding around a tracheostomy wound: what to consider and what to do? J Laryngol Otol 2009; 123: 952-56.
  • 19. Findlay JM, Sadler GP, Bridge H et al.: Post-thyroidectomy tracheomalacia: minimal risk despite significant tracheal compression. Br J Anaesth 2011; 106: 903-06.
  • 20. Gunasekaran S, Osborn JR, Morgan A et al.: Tracheal stenting: a better method of dealing with airway obstruction due to thyroid malignancies than tracheostomy. J Laryngol Otol 2004; 118: 462-64.
  • 21. Wieloch M, Koza P, Kuzdak K et al.: One-Day Thyroid Surgery – Is it Safe? Pol Przegl Chir 2013; 85: 572-81.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_1515_pjs-2015-0065
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