Pavlovsky I. Postoperative recurrent goiter: the causes, ways of prevention, treatment

The dissertation is devoted studying of the development causes of postoperative recurrences of a goiter, diagnostics, improvement of treatment methods and preventive maintenance. Results of observation and surgical treatment of patients with a postoperative recurrent goiter have been analyzed. All patients were divided into five groups according to structural, morphological and functional features. The causes for recurrence development, peculiarities of clinical implications, diagnostics, treatment methods and preventive measures have been studied in each separate group. Results of surgical treatment of patients with postoperative recurrent goiter have been estimated comparatively in two periods, which were distinguished by different approaches to selection of volume and technique of operation, namely: subfascial resection methods of operation dominated during the first period, extra-fascial hemi- and thyroidectomy dominated during the second one. The classification of causes for postoperative goiter recurrence development has been developed, according to which morphological, tactical, technical and rehabilitation reasons for recurrence development of certain clinical forms of goiter have been studied. The methods of prevention and prognosis of possible goiter recurrence in each of clinical groups have been developed. The algorithm and technique of operation concerning recurrences of a goiter, which allowed to reduce the number of specific postoperative complications more than twice have been proposed and implemented.