Optimization of the indications for surgical treatment and choice of surgery volume in patients with nodular endemic goiter and autoimmune thyroiditis

Abstract

Optimisation des indications de traitement chirurgical et choix du volume de chirurgie chez les patients atteints de goitre endémique nodulaire et de thyroidite autoimmuneIntroduction. Le traitement principal de la thyroïdite auto-immune (TAI) est conservateur. Cependant, il existe des patients atteints de TAI pour lesquels un traitement chirurgical est obligatoire. L'augmentation de l'expérience et des rapports d'interventions

"The Extent of Surgery for Unilateral Nodular Goiter With Compression Syndrome Against the Background of Autoimmune Thyroiditis"

“…NGAIT is rarely an indication for surgery, but surgery is indicated in many clinical and pathological conditions associated with AIT, such as large nodules, malignancies, symptoms of compression, etc. There are only a few articles that comprehensively consider the indications for surgery in NGAIT [11][12][13][14][15][16][17][18][19] .…”

“…According to ultrasonography data, the TG structure and blood supply, the presence, structure, volume and localization of pseudo and true nodular masses and displacement of the neck organs were studied. According to the Beskin et al ultrasonographic classification (2018), the study included patients with only the first three variants of the echographic data: hypoechoic and heterogeneous, pseudo micronodular and pseudo macronodular [9][10][11][12][13] . There were 51 patients with hypoechoic and heterogeneous variants, 27 with pseudo micronodular variants, and 23 with pseudo macronodular variants.…”

“…Thyroidectomy will eliminate the autoimmune aggression in the body, but in such cases the patient is doomed to use thyroxine preparations for life [8][9][10][11] . Hemithyroidectomy, provided that the hormone-producing function in one of the lobes of the thyroid gland (TG) is preserved, will protect the patient from unjustified thyroidectomy and lifelong thyroid hormone replacement therapy [12][13][14][15][16][17][18][19] .…”

“…The accuracy of cytological diagnosis using FNAPB is about 96.0-98.0% [8][9][10] . However, against the background of AIT, the accuracy of the morphological diagnosis of nodules decreases by about 25.0% and, accordingly, the number of questionable results increases [14][15][16][17][18] . In such cases, sequential cytomorphological and immunocytochemical studies on the same smear of puncture material increase the accuracy of cytological diagnosis [20][21][22][23] .…”