Sonographic Changes in Structure and Volume of Thyroid Gland after Local Intrasurgical Cryoexposure in Patients with Nodular Euthyroid Goiter

Authors

  • Vadim V. Khaziyev V. Danilevsky Institute of Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine, Kharkov
  • Olga V. Tjazhelova V. Danilevsky Institute of Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine, Kharkov
  • Valentina A. Makedonskaya Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine, Kharkov

Keywords:

thyroid gland, nodular goiter, ultrasonography, cryoexposure

Abstract

Comparative ultrasonic assessment of the outcomes of standard (subtotal resection of thyroid gland (TG) lobe) and combined (involving local cryoexposure) surgical treatment on TG structure and volume in the patients with uninodular non-toxic goiter was performed. Intraoperative controlled cryoexposure was carried-out using autonomous cryosurgical instrument with applicator diameter of0.2 cmand temperature of tip contact area of –140 ...–180°C. Cryoexposure was performed in the tissue of TG lobe subjected to surgery; volume of the tissue was at least 1 cm3, the exposure was single, and lasted 1 minute, which provided a sufficient amount of intact residual thyroid parenchyma not exposed to cryonecrosis. It was revealed that the standard surgical intervention led to a long-lasting reactive inflammation in the residual thyroid tissue. Sonographic observation during 12 months revealed the signs of autoimmune thyroiditis appearance and progression in 70% of patients after standard surgery and in 30% of patients after administration of application of intrasurgial cryoexposure. The findings suggested that local cryoablation exhibited immunocorrecting and preventive influence on the development of autoimmune aggression against thyroid gland in the post-surgical period. Probl Cryobiol Cryomed 2013; 23(3):240–246.

Author Biographies

Vadim V. Khaziyev, V. Danilevsky Institute of Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine, Kharkov

Department of Surgery

Olga V. Tjazhelova, V. Danilevsky Institute of Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine, Kharkov

Department of Surgery

Valentina A. Makedonskaya, Institute for Problems of Cryobiology and Cryomedicine of the National Academy of Sciences of Ukraine, Kharkov

Department of Low Temperature Preservation

References

Aleksandrov Yu.K., Agapitov Yu.N., BA Kudryavtsev B.A., Uryvchikov A.V. Ultrasound diagnosis of nodular goiter, pre-surgery and intra-surgery stages. In: Current problems of thyroid gland diseases: Proceedings of the 2nd All-Russian Thyroido-logic Congress. – Moscow, 2002 : 123–124.

Aristarkhov V.G., Kirillov Yu.B., Stroyev E.A. The problem of choice in the treatment of thyroid gland autoimmune diseases. Ryazan, 1998.

Borisova T.A., Kournikova I.A. Indicators of immune regulation in the diagnosis of hypothyroidism. Fundamentalnye Issledovaniya 2010; (9): 72–75.

Glantz S. Biomedical statistics. Moscow: Praktika, 1998.

Grebnev A.G., Chetvertnykh V.A., Zarivchatsky M.F. Morphological aspects of post-surgical hypothyroidism. Modern as-pects of the surgical endocrinology. In: Proceedings of the 15th Russian symposium of surgical endocrinology. Ryazan, 2005: 113–116.

Gubler E.V. Computational methods of analysis and recognition of pathological processes. Moscow: Meditsina, 1978.

Dedov I.I., Troshina E.A., Yushkov P.V., Aleksandrov G.F. Diagnosis and treatment of nodular goiter: Method. recommendations. – Moscow, 2001.

Zabolotskaya N.V., Kondratova G.M. Ultrasonic diagnosis of thyroid. Practical guide to ultrasound diagnostics. In: General ultrasound diagnostics / Ed. by V.V. Mitkov. – Moscow: Vidar, 2006: 607–636.

Karachentsev Yu.I. Autoimmune thyreopathies and low temperatures. Problems of Cryobiology 1998. – (3): 11–17.

Karachentsev Yu.I., Gopkalova I.V., Khaziyev V.V. Functional activity of thyroid gland in patients with diffuse toxic goiter after surgery and controlled cryoexposure. In: Proceedings of the 20th Congress of Surgeons of Ukraine. – Ternopil, 2002, Vol. 2: 531–533.

Larin A.S., Cherenko S.M. Differentiated thyroid cancer in Ukraine: the experience of the clinic in the treatment of 2000 patients and modern world trends. Vestnik Khirurgii im I.I. Grekova 2008; (3): 54–58.

Kharchenko V.P., Kotlyarov P.M. Mogutov M.S. Ultrasonic diagnostics of thyroid diseases. – Moscow: Vidar, 2007.

Epshteyn E.V., Matyaschuk S.I. Ultrasonic studies of thyroid gland: Illustated guide. 2nd Ed. – Kyiv: KVІTs, 2004.

Pat. 48626A of Ukraine, IPC7 A61V17/36. Method of surgery in thyroid gland. Yu.I. Karachentsev, V.V. Khaziyev, I.A. Lyakh, V.M. Dubovik (UA); V.Ya. Danilevskiy Institute of Endocrine Pathology Problems of Academy of Medical Sciences of Ukraine (UA). N2001107296; Filed 26.10.01, Publ. 15.08.02, Bull. N8.

Pat. 47182A of Ukraine , IPC6 A61V18/00. Method of treatment of diffuse toxic goiter. V.V. Khaziyev, Yu.I. Karachentsev, I.I. Lyakh , V.M. Dubovik (UA); V.Ya. Danilevskiy Institute of Endocrine Pathology Problems of Academy of Medical Sciences of Ukraine (UA). - N2001107296; Filed 26.10.01, Publ. 06.17.02 , Bull. N6.

AACE clinical practice guidelines for the diagnosis and management of thyroid nodules. Endocrine Practice 2006; 2 (1): 78–84.

Pomorski L.Thyroid cryotherapy in an experimental rat model – topography of temperature during therapy and functional results. Cryobiology. – 2000; 41 (1): 51–57.

Rojeski M.T., Gharib H. Nodular thyroid disease. Evaluation and management. N Engl J Med 1985; 313: 428–436.

Takashima S., Matzuzuka F., Nagureda T. Thyroid nodules associated with Hashimoto's thyroiditis: assessment with US. Radiology 1992; 185: 125.

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Published

2013-09-30

How to Cite

Khaziyev, V. V., Tjazhelova, O. V., & Makedonskaya, V. A. (2013). Sonographic Changes in Structure and Volume of Thyroid Gland after Local Intrasurgical Cryoexposure in Patients with Nodular Euthyroid Goiter. Problems of Cryobiology and Cryomedicine, 23(3), 240–246. Retrieved from https://journal.cryo.org.ua/index.php/probl-cryobiol-cryomed/article/view/300