[Personal experience with surgical treatment of thyroid diseases in childhood and adolescence]

Abstract

The authors present their experience with operations of goitre in children and adolescents. The great majority of patients was indicated by the paediatric department of the Endocrinological Institute in Lubochna. In the course of 16 years at the surgical department of the hospital and policlinic on Dolný Kubín and in the Central Military Hospital in Ruzomberok 57 patients aged 12-18 years were operated. There were 38 toxic goitres (66.7%), 19 eufunctional ones (33.3%). Fifty-six patients had a benign finding, papillary carcinoma was found once. As to hyperfunctional goitres, in 19 instances Basedow's goitre was involved, toxic juvenila goitre 16x, toxic adenoma 3x. Of the 19 eufunctional goitres nodular goitre was present 14x, diffuse nodular goitre 4x and in one instance abscendent thyroiditis. Bilateral subtotal resections were made 40x, unilateral onces 7x, total unilateral lobectomy 4x, bilateral total lobectomy and restrumectomy 1x. A cyst was extirpated 3x, in one instance an abscess of the gland was treated. In the author's opinion in particular nodular goitres are a problem as they are associated with a frequent incidence of tumours; a follicular adenoma was found 6x, papillary carcinoma once. Carcinoma on a common discrete goitre is not an exception. In carcinoma the method of choice is total bilateral lobectomy. In eufunctional benign lesions the authors recommend resection in the sound tissue with an adequate functional residue. Toxic goitres, in particular of the Basedow type, call for radical surgery, the extent of the operation depends on the character of the disease and experience of the surgeon. The objective is to achieve an eufunctional state.(ABSTRACT TRUNCATED AT 250 WORDS)