Innovative technologies in the diagnosis and safe surgical treatment of thyroid diseases

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Abstract

This study clarified the results of using innovative technologies in the diagnosis and surgical treatment of patients with thyroid diseases by evaluating the role of modern diagnostic methods and effectiveness of minimally invasive thyroid surgery. The results of a comprehensive examination and treatment of 332 patients with thyroid diseases, who were examined using modern diagnostic methods and underwent conventional and various minimally invasive approaches, were analyzed. The sensitivity, specificity, accuracy, and positive and negative predictive values of multiparametric neck ultrasonography, 99mTc-MIBI thyroid scintigraphy, fine-needle cytology, and molecular testing of thyroid nodules were compared. The minimally invasive procedure was performed in 70.4% of the patients. Postoperative complications were found in 4.9% of the patients who underwent surgery, functional dysphonia in 0.9%, and transitory hypoparathyroidism in 2.4%. The use of the main criteria that determine the choice of a rational minimally invasive surgery, such as the nodule size and thyroid volume, hyperfunctioning thyroid, clinical thyroiditis, substernal extension, extrathyroid extension, and necessity of implementation of central and lateral neck dissection due to lymph node metastases, avoids the conversion of access to the traditional approach, prevents damage to the recurrent laryngeal nerve with the development of transitory or permanent recurrent laryngeal nerve palsy, and minimizes injury to the parathyroid glands with the development of isolated cases of transient hypoparathyroidism. Therefore, results of the multiparametric analysis of the examination and surgical treatment outcomes of patients with thyroid diseases show the feasibility of using innovative technologies in their diagnosis and surgical treatment. Modern examination methods allow us to determine with great accuracy the morphological form of thyroid disease and choose a rational volume and surgical intervention. In this study, minimally invasive procedures are optimal and safe in the surgical treatment of this category of patients.

About the authors

Pavel N. Romashchenko

Military medical academy of S.M. Kirov

Email: romashchenko@rambler.ru
ORCID iD: 0000-0001-8918-1730
SPIN-code: 3850-1792

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Nikolaj A. Maistrenko

Military medical academy of S.M. Kirov

Email: nik.m.47@mail.ru
ORCID iD: 0000-0002-1405-7660
SPIN-code: 2571-9603

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Denis S. Krivolapov

Military medical academy of S.M. Kirov

Email: d.s.krivolapov@yandex.ru
ORCID iD: 0000-0002-9499-2164
SPIN-code: 2195-5001

chief surgical resident

Russian Federation, Saint Petersburg

Maria S. Simonova

Military medical academy of S.M. Kirov

Author for correspondence.
Email: mariasimonova62@gmail.com
ORCID iD: 0000-0002-8359-1875
SPIN-code: 6004-1995

surgical resident

Russian Federation, Saint Petersburg

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Copyright (c) 2022 Romashchenko P.N., Maistrenko N.A., Krivolapov D.S., Simonova M.S.

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