Novosti
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This journal is indexed in Scopus |
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Year 2015 Vol. 23 No 3
GENERAL & SPECIAL SURGERY
A.V. SHIDLOVSKY
TREATMENT OF NODULAR EUTHYROID GOITER BY LASER-INDUCED INTERSTITIAL THERMOTHERAPY
SHEE "Ternopil State Medical University named after I.Y. Horbachevsky of MPH of Ukraine",
Ukraine
Objectives. To study the possibility of using the laser interstitial thermotherapy (LITT) in the treatment of the nodular euthyroid goiter and factors influencing its efficacy.
Methods. Using LITT 134 patients with benign solitary thyroid nodes had been treated. Single silica fiber, the output power of 2,8-3,2 Watts, continuous mode of radiation, wavelength of 1060 nm, continuous ultrasound guidance had been used. Changes in the structure and volume of nodules according to the ultrasonography data were studied within the 1th day, in 2 weeks, 1, 3, 6, 9, 12 and 15 months, respectively. The gland function and level of antibodies to thyroid peroxidase were determined by standard tests prior treatment, 1 and 6 months after treatment. The long-term results were studied three years afterwards.
Results. After 24 hours the volume of nodes increased on the average to 12,2±1,21% (p <0,05). In subsequent periods of observation the sizes of nodes reduced. The final assessment of the complete replacement of nodes on the scar tissue occurred in 128 (95,5%) cases, and the volume of nodes reduced from 3,02 cm3 (range 1,2-10,2) up to 0,57 (range of 0,1-1,3; p<0,001).
Unsatisfactory result was registered in 6 (4,5%) cases without any complications. At control survey (36 months after) the volume of scar tissue remained unchanged and the parameters of thyrotropic hormone, antibodies to thyroid peroxidase were within the normal range in 68 cured patients.
Conclusion. Laser thermotherapy is considered to be a highly effective, minimally invasive, safe and inexpensive method of outpatient treatment of the nodular goiter. Its effectiveness depends on the echogenicity and volume of nodes. It can be used as an independent method of treatment in the period from clinically significant node up to the development of the compression syndrome. In some cases laser interstitial thermotherapy lets to avoid possible surgical treatment.
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46001, Ukraina, g. Ternopol, maydan Voli, d. 1,
GVUZ "Ternopolskiy gosudarstvennyiy meditsinskiy universitet
imeni I. Y. Gorbachevskogo, MOZ Ukrainyi", kafedra khirurgii 2
tel.: 380 352 52-44-92,
e-mail: shovk76@mail.ru,
Shidlovskyi Aleksandr Viktorovich
Shidlovskyi A.V. PhD, an associate professor of the surgery chair №2 SHEE "Ternopil State Medical University named after I.Y.Horbachevsky", MPH of Ukraine.
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