Afonin D. Complex intraoperative heterotopic autotransplantation of thyroid and parathyroid tissues in surgical treatment of multinodular goiter.

The dissertation is dedicated to studying the possibilities of prophylaxis and treatment of the postoperative hypothyroidism and hypoparathyroidism in the patients with two-sided multinodular goiter after operation for thyreoectomy by means of heterotopic autotransplantation of thyroid and parathyroid tissues. A complex study of the morphological properties of the grafted thyroid and parathyroid tissues, serum calcium, and also biomechanical tests after performed grafting we proved functional sufficiency of the complex autografts. Efficacy of postoperative autografting for clinic was also proved by immune tests of serum thyroid and parathyroid hormones levels, thyroid status tracking, blood calcium level measurements and also by radio isotopic assays and immune reactions for grafting. In this study we demonstrated that intraoperative heterotopic autotransplantation of thyroid and parathyroid tissues allow compensation of hypothyroidism hypoparathyroidism manifestations that develop after thyreoectomy.The analogous results were obtained after clinical application of the method. Here we also noted functional sufficiency of a new endogenic thyroid and PTH source that allows avoiding HRT. Immunity showings after operation were also noted as having positive changes. The study gives the evidence that the proposed method is effective and allows to reduce the frequency and severity of hypothyroidism and hypoparathyroidism in the late postoperative period.