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Clinical characteristics of a diffuse toxic goiter in men

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Introduction. Graves disease (GD) managements are varying. More then 40% GD patients undergo surgery in Russia. Materials and Methods. In the Centre 2920 GD patients were operated on. They made 11.7% of 24934 Thyroid (T) surgical cases during 1974-2009. This study includes 357 males (M) and 2527 females (F) observed 2-30 years after Dunhill-Drachinskaya operations (leaving 2-4 g. of some T upper pole) or thyroidectomy. Long-term results of treatment have been evaluated 2-30 years later in 336 (94.1%) males and 119 (99%) females. Statistic analysis of the data was performed using “Statistica” software. Results. Average age made 46.2 ± 2.5 years. M (43.2 ± 1.5) were significantly (p <0.05) younger then F (47.3 ± 1.8). Age of GD beginning was about 39. Duration of diseases of M was much shorter (2.1 ± 0.9) then F (7.2 ± 1.9). Cardiac fibrillation happened in 32.1% of M, 13.7% - in F, exophthalmia - in 44.4% of M, in 24.8% of F (P <0.05). Deterioration of libido and potency has observed in 40.6% and 48.9% of M (39.1 ± 0.4). Plasmapheresis was applied in 9.4% of M, 5.8% - of F. Thyroid has neck location in 55.0% of M, 62.0% - of F. T more often extended behind of sternum and trachea in M. The indication for operations: recurrent and complicated hyperthyroidism (47.0%); compression syndrome (27.0%); allergy (7.0%); oncological risk, pregnancy (19.0%). Postoperative unilateral RLN palsy was found at 0.9%, temporary hypoparathyroidism - at 1.7%. T remnant function was stabilized per the first 12-18 months. In 2-5 years later euthyroid condition observed in 63.4%, postoperative hypothyroidism - at 29.8%, subclinical hypothyroidism - at 5.4%, the relapse of thyrotoxicosis - at 1.36%. Conclusion. Clinical manifestations of M and F GD have essential differences with more aggressive course in M. Relapses of GD are rare after Dunhill-Drachinskaya T resection. Aggressive course of GD in M demands early surgical treatment.

A F Romanchishen

Email: afromanchishen@mail.ru
doktor med. nauk, professor, rukovoditel' Sankt-Peterburgskogo Tsentra endokrinnoy khirurgii, zav. kafedroy gospital'noy khirurgii s kursami travmatologii i VPKh SPbGPMU

V A Volert

kand. med. nauk, vrach-khirurg SPb GBUZ “Gorodskaya Mariinskaya bol'nitsa”

K V Vabalayte

assistent kafedry gospital'noy khirurgii s kursami travmatologii i VPKh SPbGPMU

A P Atabaev

vrach-khirurg SPb GBUZ “Gorodskaya Mariinskaya bol'nitsa"

  1. Драчинская ЕС. К технике субтотальной струмэктомии у больных базедовой болезнью. Вестник хирургии. 1948;5:18-24.
  2. Калинин АП. Диффузный токсический зоб у мужчин. Информационное письмо для эндокринологов, терапевтов, хирургов. М., 1994. 14 с.
  3. Котова ГА. Диффузный токсический зоб. В кн.: Клиническая эндокринология. СПб.: Питер, 2002:131-150.
  4. Натаров ВВ, Цариковская НГ, Караченцев ЮИ, Чапай ИИ. Хирургическое лечение диффузного токсического зоба у лиц пожилого и старческого возраста. 2-й Всерос. съезд эндокринологов: тез. докл. Челябинск, 1991:278.
  5. Пантелеев ИВ, Кириллов ЮБ, Чумаченко ПА, Аристархов ВГ. Морфофункциональное обоснование объема резекции щитовидной железы при диффузном токсическом зобе. Современные аспекты хирургической эндокринологии. Саранск, 1997:209-212.
  6. Романчишен АФ. Хирургия щитовидной и околощитовидных желез. СПб.: ИПК Вести, 2009:647.
  7. Dunhill TP. Surgical treatment of exophtalmic goiter. Aust Med Congress. 8th session, Melbourne. 1908;1:365-372.
  8. Ladenson PW, Singer PA, Ain KB et al. American Thyroid Association Guidelines for Detection of Thyroid Dysfunction. Arch Intern Med. 2000;160:1573-1575.
  9. Romaldini JH. Case selection and restrictions recommended to patients with hyperthyroidism in South America. Thyroid. 1997;7(2):225-228.
  10. Tominaga T, Yokoyama N, Nagataki S et al. International differences in approaches to 131I therapy for Graves' disease: case selection and restrictions recommended to patients in Japan, Korea, and China. Clin Endocrinol (Oxf). 1998; 49(1):21-28.
  11. Walsh JP. Management of Graves' disease in Australia. Aust N Z J Med. 2000;30(5):559-566.


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