BackgroundGraves’ disease represents an autoimmune disease of the thyroid gland where surgery has an important role in its treatment. The aim of our paper was to analyze the results of surgical treatment, the frequency of microcarcinoma and carcinoma, as well as to compare surgical complications in relation to the various types of operations performed for Graves’ disease.MethodsWe analysed 1432 patients (221 male and 1211 female) who underwent surgery for Graves’ disease at the Centre for Endocrine Surgery in Belgrade during 15 years (1996–2010). Average age was 34.8 years. Frequency of surgical complications within the groups was analyzed with nonparametric Fisher’s test.ResultsTotal thyroidectomy (TT) was performed in 974 (68%) patients, and Dunhill operation (D) in 221 (15.4). Carcinoma of thyroid gland was found in 146 patients (10.2%), of which 129 (9%) were a microcarcinoma. Complication rates were higher in the TT group, where there were 31 (3.2%) patients with permanent hypoparathyroidism, 9 (0.9%) patients with unilateral recurrent nerve paralysis and 10 (1.0%) patients with postoperative bleeding. Combined complications, such as permanent hypoparathyroidism with bleeding were more common in the D group where there were 2 patients (0,9%), while unilateral recurrent nerve paralysis with bleeding was more common in the TT group where there were 3 cases (0,3%).ConclusionsFrequency of complications were not significantly statistically different in relation to the type of surgical procedure. Total thyroidectomy represents a safe and efficient method for treating patients with Graves’ disease, and it is not followed by a greater frequency of complications in relation to less extensive procedures.
Introduction/Objective The ideal reconstruction procedure after total gastrectomy should replace all lost functions of the stomach. The aim of this study was to evaluate the usefulness of preserving the duodenal passage in subsequent improvement of body weight (BW) and body mass index (BMI) in patients with gastric cancer after total gastrectomy. Methods A total of 30 patients with gastric cancer were prospectively randomly divided into a group of reconstruction with double-tract (n = 15) and a group of reconstruction with simple Roux-en-Y after total gastrectomy. They were stratified by sex, age, their anthropometric measurements (BW, BMI), primary tumor localization, Lauren's classification, TNM stage classification, length of hospital stay, operation duration, postoperative complications, and mortality. Postoperatively, BW and BMI were measured at three, six, and 12 months and compared between the two groups. Results The clinical group of double-tract patients had significantly higher the values of BW in the postoperative period after six (66.6 ± 4.9 vs. 61.7 ± 7.6; p < 0.05 paired Student's t-test) and after 12 months (67.0 ± 4.9 vs. 62.3 ± 7.2; p < 0.05 paired Student's t-test) compared to the group of Roux-en-Y patients. On the other hand, the clinical group of double-tract patients also had significantly higher the values of BMI in postoperative period after 12 months (23.6 ± 1.1 vs. 22.5 ± 1.6; p < 0.05 paired Student's t-test) in relation to the Roux-en-Y group of patients. Conclusion Reconstruction procedure carried out after total gastrectomy which implies preserving the duodenal passage has significant increase of BW and BMI, compared to reconstruction procedure without the preservation of the duodenal passage.
Due to the reliability and simplicity of pulse oximetry it can be a routinely used diagnostic device for patients with early determined stage of lower extremities CAI.
Results of the present study suggest that there is a correlation between HCV genotype 1b and the development of HCC. Our findings also add support to the hypothesis that cirrhosis is a major step in liver carcinogenesis associated with HCV, which suggests an indirect role of HCV in the pathogenesis of HCC.
The aim of this study was to determine the seroprevalence of Helicobacter pylori and the distribution of anti-H.pylori IgA and IgG antibodies in asymptomatic children aged between 7 and 18 y. We studied the serum samples of 283 children using the commercial ELISA test for the detection of anti-H. pylori IgA and IgG antibodies. The overall prevalence of anti-H. pylori antibodies was 36.4%. The seroprevalence was 35%, 28.3%, 37.5%, and 42.2% for the ages of 7, 10, 14 and 18 y, respectively. Serum IgG antibodies alone were detected in 88.3%, IgA alone in 4.9%, and both IgA and IgG antibodies were detected in 6.8% of samples. The mean levels of IgG antibodies to H. pylori increased with age. We concluded that the prevalence of H. pylori antibodies in Serbian children was high (36.4%), ranging from 35% to 42.2%. The detection of IgG antibodies is useful for the determination of seroprevalence in asymptomatic children.
Objective: In the present study, we compared subtotal thyroidectomy (STT) with total thyroidectomy (TT) in the management of bilateral multinodular goitre. Methods: A total of 204 consecutive patients with bilateral multinodular goitre were assigned to have either TT (n = 73) or STT (n = 131). Demographic details, hospital stay, biochemical findings, indications for operation and complications were noted. Results: There was no significant difference in the age and sex ratio between the two groups (P = 0.695 and P = 0.733). According to thyroid functional status, the majority of patients were euthyroid in both groups (73.28% vs 84.90%). Goitre grades II and III presented the most common indication for STT and TT. Hospital stay for patients who underwent TT was significantly longer compared to STT (P < 0.001). There was no significant difference in the rate of permanent complications.
Conclusions:In the present study, we have shown that the risk of permanent complications with TT is no greater than with STT.
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