• Medicine · Dec 2022

    Case Reports

    Total thyroidectomy for giant nodular goiter guided by pre-operative 3D computed tomography reconstruction and 3D printing: A case report.

    • Jun Zhang, Wanli Liu, Qi Zhang, Chongru Zhao, Jie Li, Xing Li, Gezi Li, Jiali Chen, Dawei Peng, Yifei Wang, and Chang Yang.
    • Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China.
    • Medicine (Baltimore). 2022 Dec 30; 101 (52): e32456e32456.

    BackgroundNodular goiter is a common clinical problem, and thyroidectomy is preferred in patients with obstructive symptoms. Thyroidectomy is a complex procedure with some common complications. Three-dimensional (3D) computed tomography (CT) reconstruction and 3D printing provide visualized 3D anatomical structure, posing an enormously valuable potential in precise surgery with optimal efficacy and minimum complications. Here, we aimed to perform a precise thyroidectomy guided by this technology.MethodsThe patient was an 80-year-old woman with 10 years of goiter, 1 year of labored dyspnea, and a history of thyroid surgery 62 years ago. In addition to ultrasonography examination, CT images were obtained to construct the 3D model to identify the 3D relationship between the lesion and adjacent structures, and a 3D model of the trachea was created and printed using a 3D printer.ResultsThe 3D model clearly presented the diffuse enlargement of the two lobes and isthmus and the compression of the goiter. Under the 3D guidance, the operative resection specimen of the right lobe and isthmus was 12 ´ 7 ´ 5 cm, whereas the left lobe specimen was 12 ´ 9 ´ 6 cm. Nodular goiter and lymphocytic thyroiditis were confirmed by postoperative histopathology. There were no complications after total thyroidectomy except for non-permanent hypocalcemia and hypoparathyroidism.ConclusionOur results proved that total thyroidectomy for giant goiter is challenging, and 3D image-guided thyroidectomy facilitates precise and safe resection with fewer complications. 3D CT reconstruction and 3D printing can provide anatomical details and may be considered in thyroidectomy planning for patients with giant goiter.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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