Clinical signs and management strategies in thyroid masses

Yıl 2008, Cilt: 18 Sayı: 5, 294 - 299, 10.10.2008

H. Mustafa Paksoy Sedat Aydın Emin Ayduran Mehmet Eken Arif Şanlı Ömer Taşdemir

Öz

Objectives: Patients who underwent surgery for thyroid masses were evaluated with regard to clinical symptoms, diagnostic and treatment methods, and the results of treatment. Patients and Methods: The study included 92 patients 72 women, 20 men; mean age 45 years; range 16 to 71 years . Clinical diagnoses were based on findings of ultrasonography, thyroid function tests, thyroid scintigraphy, and fine-needle aspiration biopsy. Operations performed were near-total thyroidectomy n=40 , hemithyroidectomy n=25 , bilateral subtotal thyroidectomy n=16 , and total thyroidectomy n=11 . Patients with carcinoma associated with neck lymph node metastasis also underwent lateral, anterolateral, modified radical, or radical neck dissections. Results: Postoperative histopathologic diagnoses were benign colloid nodule n=70 , papillary carcinoma n=16 , medullary carcinoma n=2 , anaplastic carcinoma n=2 , and Basedow-Graves disease n=2 . Unilateral vocal cord paralysis developed in 11 patients 11.9% , five of which persisted beyond one year followup. Two patients 2.2% had transient hypocalcemia and one patient 1.1% had postoperative hematoma. Conclusion: Preoperative determination of the structure and confines of thyroid masses increases success rates of surgical procedures and minimizes complication rates.

Anahtar Kelimeler

Thyroid gland/pathology, thyroid neoplasms/ surgery, thyroid nodule/diagnosis/surgery, thyroidectomy

Tiroid kitlelerinde klinik bulgular ve uyguladığımız tedavi yöntemleri

Öz

Amaç: Kliniğimizde tiroid kitlesi nedeniyle tedavi edilen hastalar klinik bulgular, inceleme ve tedavi yöntemleri ve tedavi sonuçları açısından değerlendirildi.Hastalar ve Yöntemler: Çalışmaya 92 hasta alındı. Klinik tanı ultrasonografi, tiroid fonksiyon testleri, sintigrafi ve ince iğne aspirasyon biyopsisi bulguları ile kondu. Kırk hastaya totale yakın tiroidektomi, 25 hastaya hemitiroidektomi, 16 hastaya iki taraflı subtotal tiroidektomi, 11 hastaya total tiroidektomi uygulandı. Karsinom tanısı konan ve boyun lenf nodlarına metastaz olan hastalara lateral, anterolateral, modifiye radikal boyun diseksiyonu veya radikal boyun diseksiyonu uygulandı.Bulgular: Ameliyat sonrası histopatolojik tanılar şunlardı: Benign kolloidal nodül n=70 , papiller karsinom n=16 , medüller karsinom n=2 , anaplastik karsinom n=2 ve Basedow Graves hastalığı n=2 . On bir hastada %11.9 tek taraflı vokal kord paralizisi gelişti ve bir yıllık takip sonrasında bunların beşinde paralizi devam etti. İki hastada %2.2 geçici hipokalsemi, bir hastada %1.1 ameliyat sonrası hematom görüldü.Sonuç: Tiroid kitlelerinin yapısının ve sınırlarının ameliyat öncesinde saptanması, tedavi sonuçlarının başarılı olmasını ve komplikasyon oranlarının azalmasını sağlamaktadır

Anahtar Kelimeler

Tiroid bezi/patoloji, tiroid neoplazileri/cerrahi, tiroid nodülü/tanı/cerrahi, tiroidektomi

Kaynakça

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