A Comprehensive Approach to the Diagnosis and Surgical Treatment of Toxic Goiter

The relevance of the toxic goiter problem is determined by the high prevalence of the disease, severity of clinical manifestations of thyrotoxicosis, development of serious complications from the cardiovascular system and other organs, as well as a significant rate of relapses after conservative and surgical treatment. Despite the achievements of modern endocrinology and surgery, the problem of choosing the optimal volume of surgical intervention, preoperative preparation and prevention of postoperative complications remains relevant. The aim of the study was to improve the long-term results of surgical treatment of patients with toxic goiter through the development and implementation of a comprehensive approach to determining the volume of operation, improving surgical technique and preoperative preparation. The work was carried out at the Department of General Surgery of Samarkand State Medical University based on surgical departments of the Samarkand State Medical University clinic and City Clinical Hospital No. 1. The results of examination and surgical treatment of four hundred ninety-eight patients with toxic goiter who were treated from two thousand five to two thousand twenty-four were analyzed. Female patients predominated among the subjects, accounting for eighty-five percent, with a mean age of forty-seven years. The study demonstrated that a prognostically significant factor in the development of thyrotoxicosis relapse after subtotal thyroid resection is the preoperative titer of antibodies to thyroid-stimulating hormone receptors. The use of plasmapheresis in the preoperative preparation of patients with severe forms of thyrotoxicosis made it possible to achieve euthyroidism and prevent the development of thyrotoxic crisis in the postoperative period.