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- Title
AN EVALUATION OF THE EFFECTIVENESS OF COMBINED CARDIAC AND THYROID SURGERY OF PATIENTS WITH A HIGH PERIOPERATIVE RISK.
- Authors
Trystuła, Mariusz; Kapelak, Bogusław; Kruczek, Tomasz; Kołodziejczyk, Bartosz; Iwaszczuk, Paweł; Sadowski, Jerzy
- Abstract
Background:The simultaneous manifestation of heart disease and thyroid problems is a fairly common phenomenon. In the case of the simultaneous appearance of these complications at a advanced level of development there is the need to conduct joint endocrine surgery and a cardiac surgical operation. This is only possible in specialist units with a high level of various medical specialisations. The aim of our research is to conduct the first assessment in Poland of the effects of a simultaneously conducted operations of thyroid resection and open-heart surgery, including mainly an analysis of the postoperational complications. This is, at the same time, the most extensive pu blication to date of patients of this type to appear in English-language subject literature. Material/ Methods:Eleven patients (four males and seven females) with an average age of 66.27 years (ages ranging from 37 to 80) underwent combined thyroidectomy and cardiac surgery at the Clinical Department of Cardiovascular Surgery and Transplantology of the John Paul II Hospital in Krakow for the period from 2006 to 2014. The research employed a retrospective analysis of the hospitalization documentation as well as the results of the control tests conducted. Cases were reviewed for demographic data and past medical history, cardiac and thyroid pathology (including pathologist reports), the type of combined surgeries, heart rate, blood pressure and temperature during the operation, postoperative laboratory examinations (car diac enzymes and thyroid function markers). With the aim of evaluating complications a specialist questionnaire - The Complication Evaluation Questionnaire - was used on patients following a hybrid operation of the goitre and heart. Results: It was found that all patients survived and relatively few complications were noticed - one right recurrent laryngeal nerve palsy and one suppuration of the postoperative thoracic wound. No other complications as described in the relevant subject literature were observed, also none of the patients needed to be reoperated on. Eight patients required packed Red Blood Cells or Fresh Frozen Plasma transfusions due to extensive blood loss while only five patients needed vasoactive drug support. Conclusions:As a result of the research conducted it has been noted that the cumulative risk is less in the combined operation in comparison with that of a two-stage operations, with any ensuing complications being minor. The research conducted, as with that appearing in the relevant subject literature, shows that a single-stage procedure is safe, efficient and effective, with a good outcome.
- Subjects
CARDIAC surgery; THYROID gland surgery; ENDOCRINE surgery; SURGICAL excision; HISTORY of medicine
- Publication
Acta Neuropsychologica, 2016, Vol 14, Issue 3, p203
- ISSN
1730-7503
- Publication type
Article
- DOI
10.5604/17307503.1216043