Long-term results of surgical treatment of thyroid adenomas

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Abstract

Aim. To study the long-term results of surgical treatment of patients with thyroid adenomas.

Methods. From 2004 to 2006, 667 patients with follicular adenomas of the thyroid gland, including 134 (20.1%) men and 533 (79.9%) women, were operated on in the surgical department №2 of city clinical hospital №11 of Ryazan. 3 groups of patients were defined: group 1 — operated on for solitary adenomas of the thyroid gland, 103 patients, hemithyreoidectomy performed; group 2 — operated on for multiple adenomas of the thyroid in both lobes, 101 patients, thyroidectomy performed; group 3 — 32 patients operated on for multiple adenomas of the thyroid in the same lobe, hemithyreoidectomy performed. Patients were examined 14 years after the surgery.

Results. Hypothyroidism was diagnosed in: group 1 — 18 (17.5%) patients, group 2 — 101 (100%), group 3 — 0. All patients with hypothyroidism were compensated with hormone replacement therapy. Permanent hypoparathyroidism was diagnosed only in group 2 — 8 (4.8%) patients. Unilateral laryngeal paralysis was found in group 1 in 1 (0.9%) patient, group 2 in 2 (1.9%) patients, group 3 contained no such patients. Recurrence (node more than 1 cm according to ultrasound) was observed in group 1 in 12 (11.7%) patients; fine-needle aspiration found colloidal nodes in 8 (7.8%) patients (Bethesda II), in 4 (3.9%) — follicular tumor (IV). Group 2 had no recurrences. In group 3 11 (34.3%) patients had recurrence; fine-needle aspiration found colloidal nodes in 1 (3.1%) patient (Bethesda II), in 10 (31.3%) — follicular tumor (Bethesda IV).

Conclusion. In solitary adenomas it is possible to perform organ-saving operations, which reduces the percentage of postoperative complications; in multiple adenomas, the optimal volume of surgery is thyroidectomy; when multiple adenomas are localized in one lobe, the chance of recurrence of the disease (31.3%) is high leading to re-surgery.

About the authors

Stanislav Olegovich Artyukhin

Ryazan State Medical University n.a. I.P. Pavlov

Email: stason62-90@yandex.ru
ORCID iD: 0000-0002-9862-3462
SPIN-code: 2426-4958
Russian Federation, Ryazan, Russia

Vladimir Georgievich Aristarhov

Ryazan State Medical University n.a. I.P. Pavlov

Email: aristarhov-vladimir@mail.ru
ORCID iD: 0000-0001-9592-2048
SPIN-code: 8833-8522
Ryazan, Russia

Denis Anatolyevich Puzin

Ryazan State Medical University n.a. I.P. Pavlov; City Clinical Hospital №11

Author for correspondence.
Email: denpuzin@mail.ru
ORCID iD: 0000-0003-4511-3458
SPIN-code: 3238-7725
Ryazan, Russia; Ryazan, Russia

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