Doctors at AIIMS successfully remove goiter of 2.9kg from 60-year-old lady; 2nd largest in the world
New Delhi: Doctors at All India Institute of Medical Sciences have successfully removed a rare goiter weighing 2.9 kg from a 60 year old woman, at the end of a 6 hour long surgery. The doctors claimed that this is the largest removal recorded in India.
The patient Noorjahan, who is a resident of Moradabad in Uttar Pradesh came to AIIMS in May with a very large lump in her neck region.
According to Dr Pratyusha Priyadarshini, senior resident doctor at AIIMS’ Surgery Department, “Noorjahan was suffering from the problem for the past 20 years. She did not have any major problem in eating, breathing and was without any pain but it was putting pressure on nearby organs, causing heaviness and breathing problems”.
Initial examinations including X-ray, CT scan and thyroid functioning tests were performed after which the doctors decided on a surgery which took place on June 8.
“In such cases, the patient is usually put on anesthesia and then a tube is inserted in the tracheas for airway management. But here we wanted to insert the tube into her trachea while she was awake because of the narrowing of the trachea and then later put on anesthesia,” said Dr Priyadarshini, elaborating on the different technique the doctors adopted, taking into consideration the unusual size of the goiter.
Dr. S. Chumber, professor, department of surgery, AIIMS, calling the surgery a challenging one said, “The major problem was that the size of the goiter was very large that compelled us to modify the surgical techniques. The trachea, oesophagus, recurrent laryngeal nerve of both sides and the main vessels of the neck were close to the thyroid”.
“The patient’s trachea was wafer-thin and there were chances of stridor (noisy breathing that occurs due to obstructed air flow) due to collapsing of traches. To prevent this condition we did a temporary tracheotomy in which a tube was inserted in the windpipe to assist her in breathing,” Dr. Chumber explained.
After the surgery, the patient was kept under observation for six hours. Once her vitals were found to be stable and after eight days, the tube was taken out and she was breathing normally. The patient was discharged within three weeks and is doing fine, doctors said.
In India there has not been any such case of removal of a goiter of this size. “After reviewing the world literature, we could find similar two case reports. In one case report from Germany in 2001, huge thyroid gland weighing 5.1 kilogram was excised from a 48-year-old woman and she was discharged successfully after surgery. Another case report from Sudan in 2011 where a 61-year-old woman was operated for thyroid swelling weighing 5.7 kilogram the patient died on postoperative day two due to aspiration,” said Dr Chumber.