Guda B. Graves disease in children and adolescents: clinical features, surgical treatment and morphological characterization.

Object of study: Graves disease in children and adolescents Aim of study: To study the basic clinical characteristics, nearest and remote results of surgical treatment, morphological structure of Graves disease in children and adolescents and to develop optimum technical principles of surgical treatment and rehabilitation of patients. Methods and equipment: Clinical, statistical, biochemical, morphological; ultrasonic device Toshiba-240, microscopes Nikon, Olympus. Theoretical and practical results: At children and adolescents , like adults the certain dependence between the sizes of a thyroid gland and heavy current thyrotoxicosis has been revealed. Clinical features of Grave’s disease in children and teenagers consist in less grave lesions of visual organs, less frequent association of thyrotoxic goiter with nodular processes - compared to adults. The authors describe the morphological features of thyrotoxic goiter in children and adolescents, which consist in predominance of such histological types of morphological structure of goiter as microfollicular, normofollicular, and mixed microfollicular-solid types. In half operated children and adolescents there was evidence of papillary hyperplasia of thyroid epithelium. Possible risk factors of development hypothyroidism after surgical treatment Graves disease are determined. Preoperative preparation, anesthesia and conducting the postoperative period is advanced. Surgical treatment, a technique subtotal subfascial resections of a thyroid gland are advanced. Novelty: For the first time it has been established surgical treatment had a positive effect on the course of thyrotoxic ophthalmopathy. It has been investigated morphological characteristic Graves disease in children and adolescents. At heavy current thyrothoxicosis the microfollicular structure and attributes papillary hyperplasia have been revealed. It has been developed a new technique of definition of weight of the thyroid tissue remainder at a subtotal resection resection accordingto O.V. Nikolayev. Introduction: Practical results are introduced into clinical practice for surgical treatment Graves disease at children and teenagers. Field of application: endocrinology, surgery.