We carried out retrospective clinic-statistical analysis of patients case reports been undergone for surgery.
|Number of operations||1055||2004||3632||3551|
|TC||8 (0.76%)||41 (2.05%)||140 (3.86%)||266 (7.49%)|
|AIT||28 (2.65%)||103 (5.18%)||326 (8.89%)||523 (14.73%)|
It testifies to increase of TC and AIT within each decade, but pace of TC growth prevails over AIT. Within the last decade 18.42% of TC occurred in combination with AIT. Thus, high percentage of TC on the background of AIT forces to classify patients with AIT as a group of high risk. Such point of view dictates active tactics on a plan of surgery for AIT. Indications for surgery become often difficult and equivocal, because surgery exacerbates autoimmune process, stimulates thyroid degradation, promotes hypothyroidism. Direct correlation between increase of AIT and TC does not enable to reject surgical method of AIT treatment. Basic indications for surgery in AIT: combination of AIT and TC, high risk of pseudo nodes, compression of cervical organs, retrosternal localization, inefficiency of long medication and other non-surgical methods of treatment. Nowadays we prefer radical operations (thyroidectomy/hemithyroidectomy) for AIT. Only in cervical compression syndrome associated with AIT if no discovered nodes, inefficient medication and replacement of thyroid tissue not more for 2/3, we provided isthmus dissection with resection of medial borders of both lobes.
Conclusions: 1. Thyroid pathology is changed due to AIT and TC with certain correlation. 2. The main method of AIT management is medication but often it needs surgery. Radical operations are preferable. 3. Pre-operative examination includes all contemporary methods. In doubtful occasions of diseases identification we select surgery.
03 - 07 May 2008
European Society of Endocrinology