Shlyakhtych S. Optimizion of diffuse toxic goiter treatment on the basis of clinical and immunological features of disease duration

Object of the study:diffuse toxic goiter patients in the process of medication and surgical treatment. Objective: to optimize the treatment of diffuse toxic goiter (graves ' disease) by improving the algorithm of the treatment process based on clinical and immunological features of the disease and new approaches to surgical intervention. Research methods and instruments: clinical, instrumental, immunoassay, radioimmunoassay and statistical; ultrasound machine TOSHIBA SSA-580A, "ULTIMA PA, apparatus for welding of biological tissues EC-300М1. Theoretical and practical results: supplemented with scientific data regarding the nature of the changes of immunological parameters levels, as thyroid peroxidase antibodies (TPO Ab) and TSH receptor antibodies (TR Ab) in the process of medical treatment of Graves ' disease and defined the relationship between the quantitative value of the titer of antibody RTG and course of the disease depending on its duration. The obtained results allowed to develop and implement a treatment algorithm for patients with diffuse toxic goiter taking into account immunological parameters. Developed methods of surgical treatment of diffuse toxic goiter, which include thyroidectomy performed using the technique of electric welding of biological tissues to prevent postoperative recurrence, and to reduce time of surgical intervention and the level of intraoperative blood loss. Novelty: on the basis of a comprehensive analysis of hormonal, immunological, ultrasound indicators for the first time in Ukraine developed a standardized approach regarding the choice of the adequate tactics for the medical and surgical treatment of graves ' disease, which allows to minimize risks of complications and recurrences. Proved the effectiveness of the method of welding of biological tissues as a method of hemostasis when performing operations for graves ' disease, because it has significant advantages compared to traditional laternen way. Degree of implementation: the research results are embedded in the clinical work EAR, Kyiv city center of endocrine surgery and General surgery Central city clinical hospital №3. Patents No. 201106582; No. 201611037, No. 201006489. Field of application: endocrinology, surgery.