A.F. Romanchishen, K.V. Vabalayte, F.A. Romanchishen, E.A. Tymkiv
Saint-Petersburg State Pediatric Medical University, Saint-Petersburg
Vabalayte K.V. ― PhD (medicine), Associate Professor of the Department of Hospital Surgery with courses in traumatology and MFS
2 Litovskaya Str., Saint-Petersburg, Russian Federation, 194100, tel. (812) 275-73-60, e-mail: vabalayte@bk.ru
Abstract. Results of 44-year’s St. Petersburg Center of Endocrine surgery and oncology experience of diagnostics and treatment of 29877 thyroid patients are presented.
Material and methods. Average age of patients was 47 years. Male:female ― 1:6,7. 896 (3%) thyroid patients were operated for urgent indication. Topographic anatomy of recurrent laryngeal nerves, spinal accessory nerves and parathyroid glands were qualified on a base of 30 cadavers. They deaths were not associated with thyroid glands. Lateral and serpantinous approaches were recommended for lateral neck dissection to improve esthetic results. The spread of thyroid cancer was detected by chromothyreolymphgraphy. Intraoperative integrity neuromonitoring of neck’s and face’s nerves is using since 2000 in our Center. Literature review is adduced. Benefits of plasmopheresis in diffuse toxic patients and fotodinamic therapy in papillary thyroid cancer patients were described.
Results. Using of the said technics lead to decreasing of postoperative complications (unilateral RLN injury ― from 3,1% to 0,43%, bilateral RLN injury ― from 1,2% to 0,12%, bleeding ― from 0,61% to 0,40%, hypoparathyroidism ― from 1% to 0,46%) in period from 1974 to 2015.
Key words: thyroid cancer, neuromonitoring, disease of thyroid gland.