Immediate results of surgical treatment of autoimmune thyroiditis with the introduction of ­advanced surgical techniques

Abstract

Background. Immediate postoperative complications in the surgical treatment of autoimmune thyroiditis range from 8.5 to 15.0% of the total number of operated patients.

Aim. Improving the results of surgical treatment of patients with autoimmune thyroiditis through the introduction of advanced surgical techniques and the use of CO2 laser in surgical interventions.

Material and methods. The immediate postoperative results of surgical treatment of patients with autoimmune thyroiditis at the clinical base of the Scientific Center for Surgery named after M.A. Topchibashev for 2015–2021 were studied. The analysis was carried out in two groups with the inclusion of data from 207 operated patients aged 27 to 73 years, mostly patients with hypertrophic form of AIT. There were 183 (88.4%) women and 24 (11.6%) men. The first group consisted of 96 (46.4%) patients who underwent an advanced surgical technique using a CO2 laser. The second group included 111 (53.6%) patients who underwent surgery using traditional methods. The immediate postoperative specific complications (paresis of the larynx and hypoparathyroidism) and the results of surgical treatment of patients in two groups were compared. To test the statistical significance of differences, nonparametric Pearson's χ2 and Student's t tests were used. Differences were considered statistically significant at p <0.050.

Results. The number of patients with complications among the patients of the first group was 3 (3.1%), among the patients of the second group — 16 (14.4%) (χ2=7.870, p=0.006). The greatest number of complications was noted in patients with large goiter and recurrence of the disease in those previously operated on for autoimmune thyroiditis. The proposed method using a CO2 laser in the surgical treatment of patients with autoimmune thyroiditis can reduce the incidence of laryngeal paresis (χ2=4.057, p=0.044), hypoparathyroidism (χ2=4.381, p=0.037) and mortality (χ2=3.840, p=0.050), reduce the duration of hospital stay by 22% — from 9.6 to 7.4 days (t=2.588, p=0.007).

Conclusion. The use of advanced surgical techniques, the performance of the operation in an adequate volume and the use of a CO2 laser made it possible to reduce the number of postoperative complications and improve the results of treatment of patients with autoimmune thyroiditis.

Keywords

autoimmune thyroiditis / thyroidectomy / subtotal resection of the thyroid gland / extreme subtotal resection of the thyroid gland

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