Medicinski vjesnik, Vol. 21 No. (1-2), 1989.
Stručni rad
Current state of benign goitre surgery in the regions of Bilogora and Podravina and Slavonia and Baranja
Ivo Mlinarić
Juraj Piškorić
Krešimir Janoši
Krešimir Čandrlić
Teodor Femec
Josip Hajdin
Mladen Ivanković
Sažetak
Endemic goitre in the region of Podravina, depicted by naive painters of Hlebine school, was a considerable social and medical problem twenty years ago. Today, thanks to iodinated salt, endemic goitre and cretenism have almost completely disappeared. There are still some sporadic cases of simple goitre, but toxic nodular goitre has the highest incidence. Goitre is treated at only five out of eleven hospitals in these regions. In three hospitals it is treated at the Ear, Nose and Throat Department (ENT) and in four hospitals both at the ENT Department and at the Department of Surgery. One hospital refers all its patients to Zagreb, while two of them refer patients to Osijek. During past five years 457 patients with goitre were treated at those five hospitals: 385 in Osijek and the remaining 72 in other four hospitals. According to pathohistological findings there were 262 non toxic nodular goitres, 14 toxic nodular goitres, 37 cystic goitres, 59 diffuse toxic goitres, 57 toxic adenomas, 7 non-toxic adenomas, 2 acute thyroiditides, 9 subacute thyrioditides, 3 chronic thyroiditides and 9 diffuse hyperplastic goitres. In 428 patients the following operations were performed: 134 subtotal resections, 69 wedge resections, 50 enucleations, 154 lobectomies and 21 thyroidectomies. Only 29 patients were treated conservatively. We had the following complications: 4 recurrent laryngeal nerve paralyses, 4 haematomas, 2 reoperations and one carcinoma of the thyroid. In all patients the wound has been drained for 24 — 48 hours. Recurrent laryngeal nerves were not identified during operation. With population growing older, there is an increased incidence of nodular goitres and a decreased incidence of diffuse goitres. The number of patients treated at surgical departments is also decreasing; hence, younger surgeons have less opportunity to learn proper techniques for goitre operations. In future, multidisciplinary centres for treating thyroid diseases or departments for endocrine surgery should be formed. In that way, thyroid diseases could be properly treated at surgical departments, with the help of the ENT specialists.
Ključne riječi
goitre; goitre nodular; postoperative complications; thyroidectomy
Hrčak ID:
196773
URI
Datum izdavanja:
1.12.1989.
Posjeta: 1.601 *