THE TIME FOR SURGERY IN THYROID NODULES
The aim of the study was to improve the diagnosis and surgical treatment of thyroid nodules. Material and methods: During 2012-2022, a serial, retrospective and prospective clinical study was conducted on 124 patients, with clinically unresponsive thyroid nodules, with/without signs of compression on adjacent structures, and/or with suspected ultrasonographic, scintigraphic, cytological malignancy. Results: Depending on the hyperplastic (goiter), tumor (adenoma, carcinoma), or autoimmune etiology of nodules, surgical treatment consisted of total and subtotal thyroidectomies, unilateral hemithyroidectomies, nodules enucleation, isthmectomies, combined - unilateral hemithyroid-ectomies and enucleation of the nodule or partial contralateral lobe resections and total thyroidectomy with lymphadenectomy. In 82 patients was performed frozen section for intraoperative diagnosis of malignancy and establishing the definitive volume of thyroidectomies. Complications of the intra- and postoperative period were not determined, except for one patient who developed transient paresis of a recurrent laryngeal nerve due to posttraumatic edema in the early postoperative period, with complete recovery after one month. The relapse of pathology was not identified. Conclusions: Once detected, thyroid nodules require clinical and imaging surveillance regardless of nodule size. Surgical treatment is indicated for nodules with clinical and paraclinical signs of malignancy, refractory to conservative treatment, and those associated with compression signs. The time for surgery should be decided in common with endocrinologists, family physicians, and other specialists in every suspicious case.
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