At AIIMS, doctors cut out 2.9kg goitre

NEW DELHI: Doctors at AIIMS have successfully removed a rare goitre, swelling of the neck due to abnormal enlargement of the thyroid gland, from a 60-year-old woman. It weighed 2.91kg, which doctors claim is the largest removal case recorded in India.

Normal weight of thyroid ranges from 10-25 grams depending on age, gender and physiological status.

The patient, Noorjahan, who stays in Moradabad in Uttar Pradesh had come to AIIMS with very large lump in the neck region in May. Surgery took place on June 8. "It was a challenging surgery as it was a large goiter. We had to modify surgical techniques as the trachea, oesophagus, recurrent laryngeal nerve of both sides and the main vessels of the neck were close to the thyroid," said Dr S Chumber, professor, department of surgery, AIIMS. He said it took six hours to remove the extra-growth.

"Her 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," the doctor added.

According to Dr Pratyusha Priyadarshini, senior resident doctor at AIIMS' surgery department, the patient's vitals were found to be stable and after eight days the tube was taken out and she was breathing normally.

"Usually patient is put on anesthesia and then tube is inserted into the trachea for airway management. But here we wanted to insert the tube into her windpipe while she was awake because of the narrowing of the trachea and then she was put on anesthesia," the doctor said.

He added that in India there has not been any such case of removal of large goitre. "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.