LONG-TERM RESULTS AFTER SURGICAL-TREATMEN T OF AUTONOMIES IN THE THYROID-GLAND

In the period from 1989 to 1994 a surgical treatment of toxic nodular goiter was performed in 145 patients. An unifocal autonomous adenoma o ccurred in 69 cases, a multifocal disease 76 times. The operative stra tegy consisted in a bilateral resection 105 times, and unilateral rese ction 29 times. An excision of a single node was carried out in ten ca ses. In one operation a hemithyroidectomy on one side and a subtotal r esection of the other lobe was done. In May 1996 an interrogation abou t the current thyroid function was performed. In 105 (72.4%) patients a re-evaluation was possible. Concerning the postoperative therapy for prevention of recurrent hyperthyroidism or goiter growth, 84 patients (80%) had been treated with thyroxin and/or iodine. Under this therap y, after a mean period of 36 months 94 patients (89.5%) were clinicall y euthyroid. Nine patients (8.6%) were hypothyroid. Two patients devel oped a recurrent hyperthyroidism. Both of them belonged to the group o f patients with multifocal autonomies, and both had been treated with thyroxin postoperatively. In one case, recurrent goiter growth occurre d that did not need a therapeutic intervention. This patient as well h ad been treated for a multinodular goiter originally. She had not been taking a specific medication postoperatively. We conclude that a func tional resection of autonomic tissue in nodular goiters is efficient i n controlling the thyroid metabolism. A medical prophylaxis was not ab le to prevent recurrent hyperthyroidism in two cases.