Kobrynska N. Clinical and morphological characteristics and surgical treatment of multifocal highly differentiated thyroid carcinoma, improvement of modern surgical equipment

The work is devoted to improving the modern tactics of surgical treatment of patients with highly differentiated multifocal thyroid carcinomas to improve the patient's quality of life. A detailed comparative clinical and morphological analysis had done of groups of patients with mono- and multifocal thyroid carcinomas was carried out according to the data of the hospital register of patients of the Institute's clinic (4387 patients were researched, of which 937 were multifocal). The data obtained indicate that in a number of features, mono- and multifocal carcinomas differ significantly from each other. Thus, patients with multifocal highly differentiated thyroid carcinoma are statistically significantly older than patients with monofocal carcinomas, they are more likely to have a higher category "T" according to the pTNM classification and more often record metastatic lesions of lymph nodes, an increase in the level of thyroglobulin in the postoperative period. The number of repeated surgical interventions and other data of postoperative follow-up indicate that multifocal highly differentiated thyroid carcinomas have a more aggressive course and require more effective approaches to diagnosis and treatment. However, the obtained data prove that there is no statistically significant difference in the cases of performing prophylactic median neck dissection before its absence. A proprietary technique for the surgical treatment of patients with multifocal highly differentiated thyroid carcinoma has been developed and its effectiveness has been proven based on data from long-term postoperative observation.