MODERN DIAGNOSTIC AND MINIMALLY INVASIVE TECHNOLOGY IN THYROID SURGERY

Purpose of the study: to evaluate the role of the main instrumental methods of diagnostics and to determine the criteria for selecting patients with surgical diseases of the thyroid gland (TG) for the reasonable implementation of optimal minimally invasive surgical interventions. Materials and methods: the results of the examination and treatment of 340 patients with surgical diseases of the TG, who underwent variety of minimally invasive techniques were analyzed. Results: we compared the sensitivity, specificity, accuracy, positive and negative predictive values of the multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy TG and fine-needle cytology. Minimally invasive video-assisted procedure was performed in 29,4% patients, nonendoscopic - in 38,2%, endoscopic - in 32,4%. Postoperative specific complications were revealed in 4,4% who underwent surgery: transitory recurrent laryngeal nerve palsy - in 1,5%, transient hypoparathyroidism - in 1,6%, hematoma - in 0,8%. It was stated that the main criteria that determine the rationale for minimally invasive interventions on the TG are: the nodule size and the TG volume; hyperfunctioning thyroid and clinical thyroiditis; substernal extension; extrathyroid extension and the necessity of implementation of central neck dissection due to central and laterocervical lymph node metastases. Conclusion: the application of the determined criteria based on the integrated use of modern diagnostic techniques for patients with surgical diseases of the TG can justify the selection of optimal minimally invasive surgical interventions, avoid unreasonable operations, to avoid increasing of the frequency of specific complications, reduces surgical trauma and duration of stay in hospital, improves cosmetic outcome and enhances the quality of life of the patients.

thyroid surgery, minimally invasive video-assisted thyroidectomy, minimally invasive nonendoscopic thyroidectomy, endoscopic thyroidectomy