Endocrine Abstracts

Introduction: Endoscopic surgery has found wide application in many areas of medicine in a short: endocrinology is no exception. The main advantages of endoscopic access to the thyroid gland are the possibility of conducting endovideoscopy, a low traumatic surgical intervention, shortening of the inpatient treatment duration, periods of incapacity for work, and cosmetic effects

Goal: Determine the appropriateness of using endoscopic technologies in comparison with classical techniques in thyroid surgery procedure.

Material and Methods: During last decade, more than thousand patients with diffuse and nodular thyroid disease got thyroid surgery in the surgical department of the Brest Regional Hospital (Belarus). All patients with nodular pathology of thyroid gland underwent fine needle aspiration biopsy under ultrasound control and got cytology conclusion of nonmalignant disorder. Thyroid status was investigated in all cases (TSH, free T3 and T4, TPO-Ab). TSH receptor antibodies (TSHR-Ab/TBII) were analyzed in patients with the suppression of TSH levels, thyroid scintiography was also performed in such cases. As a routine – during surgery, all patients underwent an express biopsy. All the cases of thyroid surgery were divided depending on the type (traditional or endoscopic surgery) and volume of surgical intervention (hemi or total thyroidectomy).

Results: The results of surgical treatment of patients with thyroid diseases in a traditional way and endoscopically were evaluated according to the following parameters: the duration of surgery, intraoperative volume of blood loss, drainage of the postoperative wound, the intensity of the pain in the postoperative period, complications, the duration of hospitalization in the postoperative period, cosmetic effect. In the group of endoscopic thyroid surgery, the average length of the hospital staying was reduced to a day. Intraoperative complications occurred in 1 (0.9%) patient. Postoperative complications developed in 7 (6.2%) patients. Transient paresis of the recurrent laryngeal nerve (RN) in 5 (4.4%) patients could not be avoided. The patients who underwent surgery endoscopically, the intensity of the pain in the postoperative period was much lower compared to the usual technique. Also, a decrease in the number of intra- and postoperative complications during the endoscopic thyroid surgery was reliably established.

Conclusions: The introduction of endoscopic interventions impoves the possibility of obtaining optimal clinical results in patients with thyroid nodular diseases and reduces the number of postoperative complications, shorten the length of the patient’s stay in the hospital and the interval of rehabilitation in the postoperative period with good cosmetic effect in the operation area.