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1 Polish Journal of Surgery

1 2010

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Own Experience in Treatment of Autoimmune Goiter in the Last Decade

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Rudzki S. , Matuszek M. , Nowakowski A. , Matuszek B. , Matras P. , Wojewoda K.

Polish Journal of Surgery

2010

tom 82

nr 2

63-68

The aim of the study. The study was intended to be a retrospective analysis of clinical data concerning patients operated on for autoimmune goitre in the period 1998-2008, in the 1st Department of General and Transplant Surgery of the Medical University in Lublin.Material and methods. 1157 patients were operated on for various goitre forms. This group included 134 patients with Graves' and Hashimoto's disease associated goitre, which accounted for 11% of all goitre patients undergoing the surgery. Major indications to surgical treatment of the Graves' disease included progressive exophthalmos, goitre with compression symptoms, hoarseness, and uncertain biopsy diagnoses. As regards Hashimoto's disease, goitre with compression symptoms or with tumour-like changes, and ambiguous biopsy diagnoses were the factors qualifying the patient for surgical treatment. Statistical analysis was conducted using STATISTICA 6.0 PL software, the chi2 test was performed, and the statistical significance was established at p<0.005.Results. Graves' disease associated goitre was operated on in 72 patients, including 53 cases (39.5%) where infiltrative ophthalmopathy was also observed. Hashimoto's disease associated goitre was operated on in 62 patients. Early paralysis of the recurrent laryngeal nerve occurred in 10 (13.9%) patients operated on for Graves' disease, and in 5 (8.1%) patients operated on for Hashimoto's disease. As regards patients operated on for non-autoimmune goitre, early paralysis of the recurrent laryngeal nerve was observed in 29 (3%) cases. Post-surgical tetany was observed in 11.1% of Graves' disease patients, and in 8% of Hashimoto's disease patients. Finally, temporary post-surgical tetany was found in 2% of patients with non-autoimmune goitre.Conclusions. The type of goitre being operated on has a significant impact on the incidence of early post-surgical complications. In general, the incidence of early post-surgical complications is higher in the case of patients operated on for autoimmune-type goitre, compared with patients with non-autoimmune goitre. Yet this method is both safe and efficient. Total thyroid removal should be the treatment applied in the case of progressive orbitopathy associated with Graves' disease.