Surgical treatment of benign hyperplastical pathology of thyroid gland coupled with autoimmune changes in thyroid tissue
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StatusThe thesis was presented on the 28 June, 2006Approved by NCAA on the 28 September, 2006 Abstract – 1.21 Mb / in romanianThesisCZU 616.441 – 007.61 – 089 – 092:612.017.
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Keywords
thyroid gland, autoimmune thyrohyperplasty, subtotal thyroidectomySummary
This research reveals the results of surgical treatment of 110 patients suffering different forms of benign hyperplastical pathology of thyroid gland, operated in Surgery Clinics #2, State University of Medicine and Farmaceutics „N. Testemiţeanu”, from 1996 till 1998.
The aim of the research was to improve the diagnostic methods of detection of autoimmune changes in thyroid tissue within the pre-operation period, as well as to optimize the techniques of surgical intervention and to identify the necessary volume of thyroid tissue ablated in compliance with the degree of autoimmune changes detected.
According to the pathology character, the patients were subdivided into three groups.
The first group consisted of patients with diffuse toxic autoimmune thyrohyperplasty.
The second group consisted of patients with nodular autoimmune thyrohyperplasty.
The third group consisted of patients with mixed autoimmune thyrohyperplasty.
Each group investigated comprised a ‘control group’ consisting of patients within whose ablated thyroid tissue autoimmune changes were not morphologically detected. That helped to reveal the characteristic features of autoimmune thyroid aggression on each stage of investigation. There was suggested a diagnostic algorithm consisting of clinical, laboratory, instrumental and cytological stages of investigation.
Patients’ examination according to this algorithm allows revealing autoimmune changes in thyroid tissue within the pre-operation period in up to 90% of cases.
It was proved that surgical treatment of autoimmune thyrohyperplasties is pathogenetically grounded for the result of ablation of antigen producing thyroid tissue is the decrease in the antithyroid antibodies level. This leads to the diminution of the autoimmune aggression degree.
The treatment follow-ups within 5 years after operation were investigated in 52 patients, representatives of all the three groups. In two patients (3.8%) results proved to be unsatisfactory due to the diffuse toxic autoimmune thyrohyperplasty relapse in one case and the development of aggravated postoperative hypothyrosis in the other case.
In 39 cases (75%) the results are assessed as good, in 11 cases (21.2%) – as satisfactory.
Surgical treatment of benign hyperplastical pathology of thyroid gland taking into account autoimmune changes in thyroid tissue combined with subsequent patiens’ monitoring is a guarantee of good results, as well as of complete social and professional reabilitation of the patients.
Oficial Reviewers
- Anton (decedat) Spânu
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova - Gheorghe Ţîbîrnă
doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Oncology
Theses
