Kondov, Goran
Preferred name
Kondov, Goran
Official Name
Kondov, Goran
Main Affiliation
Email
kondov@yahoo.com
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Item type:Publication, Evaluation of Total Thyroidectomy for Treatment of Benign Diseases of Thyroid Gland(Scientific foundation SPIROSKI, 2020-04-25); ; BACKGROUND: The controversy of using total thyroidectomy (TT) in treatment of benign thyroid diseases still remains controversial over the rates of complication, mostly recurrence nerve palsy and hypocalcemia, compared to non-total thyroidectomies. The latest reports in this field of research showed that that the number of complications of TT is decreasing as the skills of surgeons increase. AIM: In this study, we reviewed 209 cases of total thyroidectomies for benign thyroid diseases where such surgery was indicated. The results were evaluated whether they support the previous reports that TT is save method of treatment of diffuse multinodular goiters, Graves’ disease thyroid adenomas with diffuse goiters and thyroiditis. METHODS: Two hundred and nine patients, 36 males and 173 females, medium age 47 (17–77) operated with TT between 2016 and 2018 were included in the evaluation study. We evaluated the: Diagnosis, indications for operation, pre-operative medication administration, laryngeal recurrent nerve palsy, hypocalcemia, hypoparathyroidism, and patohistology findings. The follow-up for hypocalcemia and laryngeal nerve palsy was performed 1 year postoperatively. RESULTS: The age of the patients was between 17 and 77 years, medium-range 47 years old. Of 209 patients, 173 (83%) were female and 36 (17%) male with a gender ratio of 1:4.8 males to females. Diagnoses before surgery were established as follows: Multinodular euthyroid goiter (MNEG) n = 106 (48.80%), multinodular toxic goiter n = 12 (5.74%), Graves’s disease n = 6 (2.87%), adenoma with multinodular goiter n = 73 (34.92%), and n = 16 (7.65%) patients with thyroiditis. Recurrence laryngeal nerve palsy (RLNP) occurred in 6 patients (2.87%), temporary within 3 months after the operation in 4 patients (1.92%) and permanent palsy within 6 months and more after an operation in 2 patients (0.95%). Voice hoarseness immediately and within 1 month after the operation was registered in 32 patients (15.3%). RLNP and hoarseness were registered mostly in patients with pre-operative problems, mostly with extra big MNEG. One of the permanent injuries of RLN was bilateral and all others were one sided. All patients were operated with normal pre-operative vocal cord movement findings. Post-operative hypocalcemia was registered in 35 patients (16.74%). Temporary nonsignificant hypocalcemia in 10 (4.78%), temporary significant hypocalcemia in 17 (8.13%), temporary severe hypocalcemia in 6 patients (2.87%), and permanent hypocalcemia in 2 patients (0.95%). CONCLUSION: Many studies have shown that the rate of complications is almost even for TT and NTT done for benign and malignant diseases of thyroid gland. Our data have shown that the risk of post-operative complications with TT is proportional to the number of complicated pre-operative findings of benign thyroid glands. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anesthetic Challenges And Management In Patient With Ataxia-Telangiectasia(Walter de Gruyter GmbH, 2023-12-01); ; ; ; Louis-Bar Syndrome is a synonym for a very rare complex neurodegenerative disorder ataxia-telangiectasia (A-T). This is an autosomal recessive inherited disease that encompasses abnormalities in the cerebellum, multisystem degeneration, immunodeficiency, increased risk for malignancy and consecutive respiratory insufficiency. Most of the patients are radiosensitive and any exposing to ionization may lead to progression of the disease. Potential risks from anesthesia, mechanical ventilation, and postoperative complications in these patients have been insufficiently discussed in the literature. We present a successful anesthetic and respiratory management with one-lung ventilation in a patient with Louis-Bar Syndrome who underwent video assisted thoracoscopy (VATS) for recurrent pleural effusion. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PRIMARY HYPERPARATHYROIDISM IN PREGNANCY(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, Macedonia, 2018-05); ; ; In this article, we report a case of a primary hyperparathyroidism in a young woman, as a result of the adenoma of a parathyroid gland, detected few days after delivery. Suspicion for primary hyperparathyroidism was achieved after different clinical features had been seen in the newborn (respiratory insufficiency, neonatal hypocalcaemia and recurrent convulsions). The aim of this article is to emphasize the importance of the early detection of hyperparathyroidism in pregnancy with adequate control of calcium, phosphates and magnesium, in order to additionally prevent disturbances of the neuromuscular feasibility and other changes in the newborn. Even though, the early treatment of hyperparathyroidism in pregnant woman, needs to be individualized for every case (conservative or surgical treatment), in this article we also present the surgical treatment postpartum and the aspects of how calcium metabolism is changed in pregnancy and why this state may be overviewed by clinicians.