[Long-term results of the surgical treatment of patients with multinodular euthyroid goiter]

Long-term results of treatment of 280 patients operated for multinodal euthyroid goiter (MNEG) in surgical department of Endocrinology Research Center RAMS from 1983 to 1997 were studied. Hormonal examination of peripheral blood, ultrasonic examination of thyroid gland (TG) and zones of regional lymph outflow, thin-needle punch biopsy were used as special methods of investigation. Correlation between recurrence and histological form was studied. In cystic-colloid goiter with adenomatosis the recurrence of MNEG was revealed in 15 (34.1%) cases. In primary multiple TG adenomas of different types the number of recurrences was smallest--1 (3.3%) cases. There were no recurrences in cancer of TG in combination with cystic-colloid goiter or adenomas of TG. Recurrence of cystic-colloid goiter was revealed in 5 (5.7%) cases, different types of adenomas--in 5 (5.7%) cases. The smallest number of recurrences of MNEG was seen after maximum subtotal resection of TG--in 4 patients (7.7% of the patients with this volume of operation). In all the 12 cases of partial resection of TG the recurrence of different morphological forms of MNEG was revealed. Influence of thyroid therapy on remote recurrence rate in different form of MNEG was also studied. In cystic-colloid goiter (CCG) of different proliferation degree with adenomatosis the recurrence rate was not significantly different irrespective of hormonal therapy--29.4%, 37.5% and 36.4%, respectively, in adequate therapy, inadequate therapy and its absence, that testifies to small influence of thyroid therapy on reduction of recurrence rate in this group of patients. The highest recurrence rate in CCG and CCG with adenomas of TG was revealed in the group without thyroid therapy--30.8% and 35.7%, respectively.