Goiter relapses

Abstract

The problem of relapse of goiter is still considered insoluble. Postoperative relapses of goiter are observed quite often - from 1.8 to 39%.

The severity of the problem of recurrent goiter is that at present, patients suffering from this disease can be attributed to the group of "increased oncological risk" in relation to thyroid cancer. Malignancy of recurrent goiter, according to various authors, is observed with a frequency of 8.1 to 20%. Malignancy occurs “hidden” without clear clinical symptoms of thyroid cancer, and therefore surgical intervention is often performed at a stage that does not give optimal treatment results.

The second side of the problem is the technical features of the surgical treatment of recurrent goiter. The latter are caused by violations of the anatomical and topographic relationships of tissues, extensive scars and atypical location of the node. As a result, complications and mortality after repeated operations with goiter significantly exceed those after primary interventions. Therefore, one of the tasks of thyroid surgery is to find out the causes of relapse of goiter and reduce its frequency.

For this purpose, various methods of primary surgery, the intake of thyroid hormones in the postoperative period, etc. are proposed.

The reasons that lead to relapse of goiter are varied and depend primarily on the disease for which the patient was operated on primarily (diffuse toxic goiter, nodular goiter, multinodal, chronic autoimmune thyroiditis, etc.). To avoid relapse of goiter, a number of surgeons offer more advanced operations even with nodular goiter. However, the expansion of the volume of operation with nodular forms of goiter often leads to the development of persistent hypothyroidism.