Evaluation of thyroid gland scintigraphy and thyroid gland ultrasonography from the surgical viewpoint]

The results of thyroid ultrasound and scanning on 251 patients have been reviewed in regard of the postoperative histological findings. Both procedures (thyroid ultrasound and scanning) cannot predict the histology. But with ultrasound adenomas of the thyroid for example could be localized in 93%, with isotope scanning only in 74%. Merely 2% of cold nodules with decreased or mixed sonographic pattern have been malignant. Ultrasonography is extremely helpful for the surgeon in his operative planning.     

Papillary carcinoma of the thyroid. Recurrence in the thyroid gland after initial surgical treatment

The purpose of this study was to evaluate the clinical significance of multicentricity of papillary carcinoma by determining the incidence of recurrent carcinoma in the remaining thyroid gland after primary surgical treatment. “Clinical recurrence” usually implies reactivity of the primary tumor which is discernible to the clinician. However, in this report it is used in a broader sense to denote microscopic, minute or gross evidence of cancer found in the remaining thyroid gland after the initial surgical procedure. In the narrower sense some of these are not “clinical recurrences” in that they were not grossly visible or palpable but are included in determining our incidence of “clinical recurrence.” If they were excluded, our percentages of “clinical recurrence” would be much lower.     

Video-assisted surgical interventions on the thyroid gland

Results of endovideosurgical treatment of thyroid diseases in 137 patients are analyzed. Ultrasonic scissors allow surgery from mini-approach 2-3 cm long, to refuse ligatures and drainages, to suture surgical wound with intracutaneous cosmetic suture, to discharge patients in 3 days after surgery. All the patients had uneventful postoperative period.     

Five-year experience of surgical treatment of the thyroid gland tumors in regional oncological dyspensary

In 1998-2003 in dispensary there were treated 39,085 patients for different oncologic diseases, of them 360 (0.92%)--for diseases of the thyroid gland. There were 147 (40.8%) of patients operated on.     

Results of surgical treatment of nodular diseases of the thyroid gland in senile patients

The article presents an analysis of results of surgical treatment of 90 patients aged older than 75 years (mean age 78.0+/-2.8 years) with nodular diseases of the thyroid gland. The influence of a concomitant pathology in other organs on the course of diseases of the thyroid gland was established. It was noted that in senile patients malignant tumors appeared three times more often against the background of a benign pathology of the thyroid gland than in young patients. Main indications for surgical treatment were compression syndrome and cancer of the thyroid gland. The results of treatment of malignant tumors of the thyroid gland in senile patients and causes of postoperative complications were studied. Unfavorable results of treatment were due to prolonged observations at the pre-admission stage, predominance of patients (63.0%) with the 4th stage of disease, almost half of them had anaplastic cancer.     

The ratio of nosological forms and surgical tactics in the treatment of the thyroid gland diseases

The dynamics of morphofunctional changes of the thyroid gland tissue was analyzed in patients with the organ diseases in 1995-2003. It was established, that geochemical environmental factors constitute the cause of the nodous goiter occurrence. The environment soiling causes the thyroid gland tissue dysplasia and the cancer occurrence. The surgical tactics in the thyroid gland diseases was adduced.     

Surgical treatment of the hallux valgus through mini-approach

A mini-invasive surgery implies a diminution of the morbidity of the surgical procedure, which relies on three conditions: not only a reduction of the skin incision, but also a limited dissection applied to the approach and the preparation, and a surgical step resulting in as little bleeding, debris, heat and fibrosis as possible. The recent, rapid and varied evolution of the mini-invasive techniques, concerns all the surgical disciplines, and reflects the technical progress, the very prevailing concern for morbidity risk, competition and fashion phenomena. However, this evolution also attests to the excellence of the surgical techniques. In the surgery of the hallux valgus, we are less focused, on the correction methods, which are now reliable, and our main concern for perfection is centered on the reduction of the approaches. The technique we are reporting is only one of the possible procedures of mini-invasive surgery of the hallux valgus.     

The thyroid gland scintigram. A decision aid for the surgical approach in thyroid gland diseases?

For the operative proceeding thyroid scintiscan seems widely dispensable in many routine cases as it leads neither to a different operative strategy nor to an improvement of surgical results. In a few selected cases, however, operative proceeding is determined by scintigraphic results. Thus the question of the importance of scintigraphic methods for thyroid diagnostics and therapy as well as for the selection of patients for surgery cannot be answered and must be subject of a separate examination.     

Extensive surgical treatment of advanced or recurrent carcinoma of the thyroid gland: report of three cases

Three advanced or recurrent thyroid carcinomas invading the adjacent surrounding organs such as trachea, great vessels or anterior mediastinum were reviewed. In one patient, resection of subtotal thyroid combined with trachea including a part of cricoid cartilage was performed, and followed with end to end anastomosis. In the other two patients with SVC syndrome, a trans-sternal surgical approach was applied in order to resect a large tumor extending into the anterior mediastinum. Replacement of SVC with ringed PTFE graft and chest wall resection was performed in one patient. With these extended surgical intervention, more operative radicality, prolonged surviving time and better quality of life were expected.     

Autoimmune reactions in patients with surgical diseases of thyroid gland

Possibility of detection of autoantibodies toward thyroidal tissue, using reaction of the compliment bounding in the cold, was studied for raising of the diagnosis and differential diagnosis efficacy in surgical diseases of thyroid gland. The results obtained witness the possibility of application of the method in diagnosis of the thyroid gland surgical diseases. In nodular goiter the antibodies titer had constituted 1:10-1:20, in cancer of thyroid gland-- 1:40-1:80. Accessibility of the method permits to recommend it for application in screening procedures.     

甲状腺韧带解剖的再认识以及甲状腺手术新路径的研究

目的探讨气管前筋膜、外侧韧带（Berry韧带）、悬韧带在甲状腺固定中的作用,以及易于解除甲状腺固定的中间入路新手术路径的效果。方法采取甲状腺中间入路的手术方法完成甲状腺手术326例。术中常规切断游离气管前筋膜、外侧韧带、悬韧带,解除甲状腺固定（即甲状腺松动）。结果本组术中甲状腺松动的完成率为98．5％（321／326）。手术平均时间75（45～130）min。术中平均出血量23（5-126）ml。2例再次甲状腺手术和3例甲状腺癌手术出现轻度喉返神经麻痹症状,分别于1、3、6个月后恢复,无永久损伤。术后平均住院时间4．5（3-6）d。结论中间入路新手术路径的目的是首先解除气管前筋膜、外侧韧带、悬韧带对甲状腺的固定,甲状腺得以松动后再进行血管游离以及其他手术步骤,使甲状腺的切除手术变得容易操作,同时使手术并发症减少。