Endocrine Abstracts

Introduction: Prevention of surgical complications in patients with severe forms of Graves’ disease is still not completely solved problem. The purpose of research was improve the results of surgical treatment of patients with severe Graves’ disease.

Materials and methods: In 2012 introduced a method of treatment of patients with Graves’ disease SETA as a preoperative preparation. Presented results of surgical treatment of 30 patients, with severe forms of Graves’ disease. The patients were divided into two groups. Main group consisted of 15 patients before strumectomy using SETA, was 5 (33%) men and 10 (67%) women aged 26–52 years old,and in the control group, in which 15 patient performs subtotal strumectomy, was 4 (26.6%) men and 11 (73.3%) women aged 26–63 years.

Results: SETA way used by us as pre resective preparation for 3–4 days prior to strumectomy. During this time, achieved by reducing the volume of the thyroid, the reduction of blood flow in the thyroid tissue, potentiation thyrostatic preoperative therapy, a significant reduction in intraoperative blood loss. The degree of thyroid enlargement in all patients corresponded to grade two (by WHO), with decompensated thyrotoxicosis. To all 30 patients performed subtotal strumectomy. The total duration of the operation in the control group was on average 63.7±6.1 min. In the basic mean duration of surgery was less and was 45.4±5.8 min. In the analysis of postoperative complications in 1 (6.3%) patients of the control group was thyrotoxic crisis, moderate postoperative bleeding was observed in 3 (20%) in the control group. In the basic group without complications. No deaths among patients.

Conclusions: SETA in patients with severe Graves’ disease in the pre resective period in considerable reduction effects of hyperthyroidism, thyroid volume reduction compared to the original, enables significantly reduced intraoperative blood loss, which facilitates the technique of the operation. SETA can reduce operating time to 26%, the amount of intraoperative blood loss – to 52.5%, and avoid bleeding in the early postoperative period. Further study results SETA also as an independent treatment option for Graves’ disease.