Novosti
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Year 2012 Vol. 20 No 5
GENERAL AND SPECIAL SURGERY
G. A. BLUVSHTEIN, V.V. GREKOV
COMPILCATIONS IN MORPHOLOGICAL DIAGNOSTICS OF THE THYROID GLAND DISEASES
State Budgetary Educational Establishment of Higher Professional Education “Saratov State Medical University named after V.I.Rasumovsky”, Saratov,
The Russian Federation
Objectives. To study sensitivity, accuracy and specificity of pre- and intraoperative cytological examination of the nodular goiter, and also the reasons of false positive and false negative results of the cytological examination.
Methods. The results analysis of surgical treatment of 933 patients with different forms of nodular goiter for a 3-year period (2007-2009) was carried out. Data of the fine needle aspiration biopsies and intraoperative cytological examination were compared with the results of histological examination of the operative mate-rial.
Results. Preoperative cytological examination appeared to be informative in 915 cases out of 933 or in 98,1%. The application of the preoperative complex as well as intraoperative cytological examination permitted to determine correctly the character of the thyroid gland lesion, its morphological form and on the basis of these data to choose an adequate volume of the operation in 94,6% of observations. False positive results of the cytological conclusions on the thyroid gland cancer were in 22 patients (2,3%), false negative results were in 29 patients (3,1%).Intraoperative cytologi-cal examination of the touch smears permitted to improve diagnostics results and to verify the malignant tumor in 16 more patients with the thyroid gland cancer. Coincidence of the data of pre- and intraoperative diagnostics with postoperative planned histological examination composed 91,1% at the thyroid gland cancer, 86,8% – at the nodular colloid goiter, 54,2% – at autoimmune thyroiditis.
Conclusions. The performed research certified that up to present one has faced difficulties in the preoperative verification of the nodular growths of the thyroid gland. There are no special techniques permitting to exclude the malignant nodular tumor growth before the operation absolutely certainly.
Complex application of the preoperative fine needle aspiration biopsy with the consequent obligatory intraoperative cytological examination contributed to the improvement of diagnostics quality of the nodular goiter and permitted to choose an optimal type and volume of the operation.
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410012, Rossiyskaya Federatsiya, g. Saratov, ul. Bolshaya Kazachya, d. 112. GBOU VPO «Saratovskiy gosudarstvennyiy meditsinskiy universitet im. V.I. Razumovskogo», kafedra fakultetskoy khirurgii i onkologii,
e-mail: grekoffvv@mail.ru,
Grekov Vladimir Vladimirovich
Grekov V.V. Assistant of the Faculty Surgery and Oncology Chair of SBEE HPE “Saratov State Medical University named after V.I.Rasumovsky”.
Bluvshtein G. A. Doctor of Medical Sciences, Professor, Head of the Faculty Surgery and Oncology Chair of SBEE HPE “Saratov State Medical University named after V.I.Rasumovsky”.
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