This journal is
indexed in Scopus
Year 2019 Vol. 27 No 3
GENERAL & SPECIAL SURGERY
S.N. ZAVGORODNIY, M.A. KUBRAK, M.B. DANYLIUK
SIMULTANEOUS OPERATIONAL INTERVENTIONS IN PATIENTS WITH THYROID PATHOLOGY
Zaporizhzhia State Medical University, Zaporizhzhia,
Objective. To improve the diagnostic of combined surgical diseases and evaluate the results of simultaneous surgical interventions performed in patients with thyroid pathology.
Methods. A retrospective analysis of case histories of 564 patients with the thyroid gland (TG) diseases was performed. The main group consisted of 247 (43.8%) hospitalized patients who were examined according to the developed diagnostic algorithm for combined surgical pathology. The comparison group included 317 (56.2%) patients examined according to the diagnostic and treatment protocols for patients with endocrine pathology approved in Ukraine. The levels of detection of combined surgical pathology, its structure, indicators of simultaneous operations, postoperative complications and mortality in both groups were evaluated using statistical methods of analysis.
Results. In the comparison group, 21 (6.6%) patients had a combined surgical pathology. In the main group – in 61 (24.7%) of the examined. 55 (90.2%) patients of the main group and 18 (85.7%) operated on in the comparison group underwent simultaneous surgical intervention. The level of simultaneous operations in the main group was 22.3%, in the comparison group – 5.7%. In 7 (12.7%) patients of the main group and in 2 (11.1%) of the comparison group, postoperative complications occurred. Lethal cases in both groups were not recorded.
Conclusions. The use of the developed algorithm for examining patients with thyroid pathology allowed an increase in the diagnostic of combined surgical diseases from 6.6% to 24.7%, χ2=9.342, p<0.01. This made it possible to increase the number of simultaneous operations performed from 5.7% to 22.3%, χ2=8.692, p<0.01. An increase in the percentage of simultaneous surgical procedures performed does not increase in mortality rates and postoperative complications.
- Kravchenko V², Postol SV. Dinam³ka zakhvoriuvanost³ na patolog³iu shchitopod³bno¿ zalozi v Ukra¿n³. Mezhdunar Endokrin Zhurn. 2011;(3):26-31. http://www.mif-ua.com/archive/article/17759 (in Russ.)
- Cosar R, Sari IK, Durmaz SA. Concomitant Graves’ disease and primary hyperparathyroidism: case report. Endocrine Abstracts. 2015;37:EP946. doi: 10.1530/endoabs.37.EP946
- Panarese A, D’Andrea V, Pontone S, Favoriti P, Pironi D, Arcieri S, Filippini A, Sorrenti S. Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study. Aging Clin Exp Res. 2017 Feb;29(Suppl 1):29-33. doi: 10.1007/s40520-016-0665-8
- Nikonenko AS, Zavgorodnii SN, Golovko NG, Klimenko AV, Gaidarzhi EI, Vil’khovoi SO, Dolia OS, Detsyk DA, Rusanov IV, Podluzhnyi AA. Simul’tannye operatsii pri khirurgicheskom lechenii bol’nykh s endokrinnoi patologiei. Suchasni Medichni Tekhnolog³¿. 2013;(3):137-39. http://www.zmapo-journal.com.ua/uk/arhiv-nomeriv-zhurnalu/2013-rik/vipusk-2-2013 (in Russ.)
- Zavgorodniy SM, Kubrak MA, Rylov AI, Danilyk MB. Diagnostic algorithm in combined surgical pathology in patients with diseases of endocrine system. Mezhdunar Endokrin Zhurn. 2017;13(8):591-95. doi: 10.22141/2224-07188.8.131.527.119276 (in Russ.)
- Spanheimer PM, Weigel RJ. Management of patients with primary hyperparathyroidism and concurrent thyroid disease: an evolving field. Ann Surg Oncol. 2012 May;19(5):1428-29. doi: 10.1245/s10434-012-2286-6
- Emirikҫi S, Özҫ?nar B, Öner G, Omarov N, Ağcaoğlu O, Soytaş Y, Aksakal N, Yanar F, Barbaros U, Erbil Y. Thyroid cancer incidence in simultaneous thyroidectomy with parathyroid surgery. Ulus Cerrahi Derg. 2015 Aug 18;31(4):214-17. doi: 10.5152/UCD.2015.2666. eCollection 2015
- Simsek B, Guldogan CE, Ozden S, Saylam B, Karabeyoglu SM, Tez M. Concomitant thyroid cancer in patients with primary hyperparathyroidism in an endemic goitre region. Ann Ital Chir. 2017;88:15-19. https://www.annaliitalianidichirurgia.it/PDF/2017/03_2622+blocco.pdf
- Morris R, Yen TWF, Doffek K, Carr AA, Wilson SD, Evans DB, Wang TS. Concurrent endocrine and other surgical procedures: an institutional experience. J Surg Res. 2017 May 1;211:107-13. doi: 10.1016/j.jss.2016.12.013
Zaporizhzhia, Mayakovsky Ave., 26,
Zaporizhzhia State Medical University,
Department of Surgery and Anesthesiology
Of the Post-Graduate Training Faculty.
Tel. +38 095 700-78-93,
Mykhaylo A. Kubrak
Zavgorodniy Sergey N., MD, Professor, Head of the Department of Surgery and Anesthesiology of the Post-Graduate Training Faculty, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine.
Kubrak Mykhaylo A., Senior Laboratory Assistant of the Department of Surgery and Anesthesiology of the Post-Graduate Training Faculty, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine.
Danyliuk Mykhailo B., PhD, Assistant of the Department of Surgery and Anesthesiology of the Post-Graduate Training Faculty, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine.