Modification of treatment of postoperative hypoparathyroidism in operational treatment of thyroid cancer with various lymphodissectic types

Abstract

Relevance. According to these studies from (2015), where a total of about 2000 patients were examined, the prevalence of hypoparathyroidism was about 24 per 100 000 population, while only 2 per 100 000 hypoparathyroidism was not surgical etiology. These indicators correspond to those of the United States and Europe, where a similar situation is observed. However, the main role belongs to the problem of persistent postoperative hypoparathyroidism and does not address the issue of the frequency and dependence of transitional hypocalcemia after various types of operations on the thyroid gland. And the main protocols for the treatment of this pathology are only recommendatory in nature and require constant improvement. Aim. To study the effectiveness of the protocol for the treatment of hypoparathyroidism in the early postoperative period. Conduct a comparative evaluation of the effectiveness of the modified protocol for the treatment of postoperative hypoparathyroidism. Materials and methods. During the period from 2014 to 2016 in the municipal hospital "City clinical hospital emergency and emergency medical care in Zaporozhye, on the basis of the Department of Surgery and Anesthesiology FPE, ZSMU, conducted a study of the effectiveness of treatment of hypoparathyroidism in the early postoperative period and developed a modification of this protocol. During the reporting period, 116 operative interventions for differentiated thyroid cancer were performed. Women were 108 (93,1%), men 8 (6,8%). The mean age of the patients was 50,8±12,8 (age 21 to 80 years). All patients were operated in a planned manner. We performed 52 (44,8%) thyroidectomy with central lymph node dissection (removal of the 6th group of pre- and paratracheal lymph nodes) and 64 (55,2%) thyroidectomy with central and unilateral lateral lymph node dissection from the tumor side (fascial-luminal dissection 2-5 cervical lymphatic collectors). To study the effectiveness of the protocol for the treatment of hypoparathyroidism in the early postoperative period, two groups were formed: a comparison group – 34 patients (29,3%) who underwent diagnostics and treatment of hypoparathyroidism in the early postoperative period in accordance with the standard recommendations of the Ministry of Health of Ukraine and the main group included 82 patients (70,7 %), who underwent a modification of the protocol for the treatment of hypoparathyroidism in the early postoperative period, developed at the Department of Surgery and Anaesthesiology FPE, ZSMU.