Special aspects of surgical intervention in patients with nodular goiter combined with autoimmune thyroiditis

Abstract

Surgical intervention in patients with nodular goiter combined with autoimmune thyroiditis (AIT) is characterized by certain difficulties determined by the development of autoimmune processes in the thyroid tissue resulting from autoimmune aggression, as well as by presence of nodular formations in the thyroid gland (TG). As a result of autoimmune processes the autoimmune inflammation develops both in the thyroid tissue and in the surrounding anatomical structures. Reduction of ligaments between the trachea and the TG occurs, resulting in thyroid tissue is pulled to the side walls of the trachea and tracheoesophageal grooves, and the fragility of vessels in shrunken ligaments and fasciae is observed. It contributes to the development of topographic changes of the anatomical relationship between the TG and surrounding tissues and organs. We have operated on 137 patients with nodular goiter in combination with AIT using the above described technique of surgical intervention. This allowed us to reduce the number of complications caused by the surgery, which are damage to the recurrent laryngeal nerves, parathyroid glands, and bleeding.