Article Sidebar
Views PDF: 410
Evaluated respiratory problem in goiter compressing trachea
Main Article Content
Abstract
BACKGROUND: Some studies indicate that 33% of goiter patients have symptoms of compression. A pinched thyroid disease is one of the surgical designations of goiter. Compression symptoms are not only clinically relevant for the patient, but are also a problem for general anesthesia and resuscitation.
METHODS: Retrospective cross-sectional description. We recruited 52 patients diagnosed with tracheotropic goiter to undergo medical examination and surgery at the Department of Thoracic Surgery at Cho Ray Hospital from January 2015 to the end of March 2019. Exclusion criteria: Patients with cervical tumor combined to cause compression of the trachea, Thyroid cancer with image of invasive trachea on CT scan.
RESULTS: The average age of the study group was 62.15 ± 12.71, the male / female ratio was approximately 1: 4. At the time of admission, 3 cases were being treated for pneumonia, 4 were undergoing intubations and 1 had a tracheotomy in a total of 52 cases, so 15.38% of patients had respiratory problems in time of admission. The smallest diameter of trachea is 3 mm. The mean minimum trachea diameter is calculated to be 8.15 ± 3.40. Narrow tracheal grouping, the majority of patients were from 5 to 10 mm size, accounting for 73.1%. The proportion of patients with difficult intubation was 61.5%. The good result of surgery is 86.54%, the rate of complications after surgery is 13.46% including complications of respiratory failure, hand numbness, vocal paralysis and mediastinal fluid, besides there are no deaths. The rate of respiratory failure after surgery is 3.8%. The rate of re-intubation was 1.9%. Only 2 cases of trachealmalasia were detected in surgery and both cases were treated by tracheostomy.
CONCLUSION: Surgery to treat tracheal goiter for good early results. Surgery in the early stage helps the patients recovered respiration quickly after surgery. During surgery, attention should be paid to the following issues: anesthenesis, trachealmalasia and vocal cord paralysis.
Article Details
Keywords
goitre compressing trachea, trachealmalasia, tracheal stenosis
References
2. Banks, C.A., et al., Thyroid disease and compressive symptoms. Laryngoscope, 2012. 122(1): p. 13-6.
3. Alfonso, A., et al., Tracheal or esophageal compression due to benign thyroid disease. Am J Surg, 1981. 142(3): p. 350-4.
4. Freitag, L., et al., A proposed classification system of central airway stenosis. Eur Respir J, 2007. 30(1): p. 7-12.
5. Fujita, T., The Natural History of Multinodular Goiter. Journal of the American College of Surgeons, 2015. 221(4): p. 893-894.
6. Hoàng, B.V., Đánh giá kết quả điều trị Ngoại khoa bướu giáp lành tính thòng vào trung thất. 2016, Đại học Y dược TP. HCM. p. 6.
7. Sajid, B. and K. Rekha, Airway management in patients with tracheal compression undergoing thyroidectomy: A retrospective analysis. Anesthesia: Essays and Researches, 2017. 11(1): p. 110-116.
8. Stang, M.T., et al., Positional Dyspnea and Tracheal Compression as Indications for Goiter ResectionPD and TC as Indications for Goiter Resection. JAMA Surgery, 2012. 147(7): p. 621-626.
9. Dempsey, G.A., et al., Anaesthesia for massive retrosternal thyroidectomy in a tertiary referral centre. Br J Anaesth, 2013. 111(4): p. 594-9.
10. Sorensen, J.R., et al., Thyroidectomy Improves Tracheal Anatomy and Airflow in Patients with Nodular Goiter: A Prospective Cohort Study. Eur Thyroid J, 2017. 6(6): p. 307-314.
11. Chừng, T.t.C.N.L.V.Q.N.V., Nghiên cứu những yếu tố tiên lượng khó đặt NKQ trong phẫu thuật bệnh lý tuyến giáp. Tạp chí Y học TP. Hồ Chí Minh, 2011. 15: p. 75-80.