S.N. PAMPUTIS, I.E. BELYAKOV, A.D. DYAKIV, Yu.K. ALEKSANDROV

Yaroslavl State Medical University, Yaroslavl

  Contact details:

Aleksandrov Yu.K. ― MD, Head of the Department of surgical diseases

Address: 5 Revolyutsionnaya Str., Yaroslavl, Russian Federation, 150000, tel. (4852) 30-56-41, e-mail: yka2000@mail.ru

 Objective. The study is devoted to the evaluation of diagnostic capabilities of radiation diagnostic methods at the preoperative examination of the patients with nodular goiter of large sizes.

Material and methods. Preoperative examination and operative treatment of 616 patients with thyroid gland diseases were performed. For topical diagnostics (determining the size, location and interaction with surrounding tissues), radiation diagnostic methods were used: ultrasound, x-ray computed tomography, and magnetic resonance imaging.

Results. It was found that, along with the clinic of compression syndrome, the complex of basic and additional diagnostic methods (ultrasound, x-ray computed tomography and magnetic resonance imaging) can be expanded by obtaining preliminary data on the large size of the gland. According to the examination results, despite the large size of the thyroid gland, the compression syndrome was clinically and instrumentally established only in 15 people (26.8% of the examined patients). At the same time, large size of the thyroid gland creates difficulties during anesthesia (in particular, intubation and laying) and surgery, significantly affect the technique and sequence of stages of the operation. With the large size of goiter, ultrasound does not allow to reliably assess changes in the thyroid and surrounding tissues, which is due to limitations of the method. The authors proposed an algorithm showing the sequence, indications and appropriateness of various methods of radiation diagnostics for patients with large size thyroid gland (more than 150 g).

Conclusion. It is recommended to expand indications for x-ray computed tomography and magnetic resonance imaging for patients with thyroid gland pathology. In particular, they are proposed to be included as obligatory diagnostic methods into pre-operation examination of patients with large size thyroid gland (more than 100 cm³).

Key words: goiter, surgical treatment, ultrasound, multispiral computed tomography, magnetic resonance imaging.

(For citation: Pumputis S.N., Belyakov I. E., Dyakiv A.D., Aleksandrov Yu.K. Features of preoperative evaluation of patients with a goiter of large sizes. Practical medicine. 2019. Vol. 17, № 4, P. 133-136)

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