ABSTRACT
BACKGROUND: One of the main difficulties in assessing the effectiveness of etiologic treatment of hypoparathyroidism is absence of its standardized model. OBJECTIVE: The aim of the study was to develop a method of hypoparathyroidism modeling. METHODS: Controlled nonrandomized study was performed on female Wistar rats aged 10 month. Group 1 (n =14) was performed with destruction of parathyroid glands with electrocoagulation; group 2 (n =12)--parathyroidectomy by the developed method. In 3 and 14 days after the surgery the levels of ionized calcium, parathyroid hormone, number of white blood cells, blood leukocyte formula, indicators of immunological tests, histological examination of organs in the area of operations were performed. Statistical analysis was performed using the nonparametric Mann-Whitney-Wilcoxon test. RESULTS: Selection of animals by sex and age criteria, angular skin incision, use of the operating microscope, microsurgical techniques, extirpation of parathyroid glands via resection of thyroid gland with the closure of the wound defect glue appeared to be the distinctive features of the developed method. In 14 days the group 2 showed decrease in ionized calcium (p = 0.016), PTH (p = 0.094), leucocytes (p = 0.004), PI (p = 0.003), spontaneous NBT test (p = 0.004), induced NBT test (p = 0.003) compared with group 1. Histological examination in the group 2 revealed no changes in thyroid gland, thin connective tissue capsule, cavity with a small amount of glue, however, there were determined foci of necrosis with perifocal inflammation in the group 1. CONCLUSION: Combination of several techniques allowed to simulate metabolic disorders with persistent hypocalcemia as well as lack of mortality in early postoperative period.
Subject(s)
Acrylic Resins/pharmacology , Electrocoagulation , Hypoparathyroidism/etiology , Intraoperative Complications/prevention & control , Parathyroidectomy , Animals , Disease Models, Animal , Electrocoagulation/adverse effects , Electrocoagulation/methods , Female , Intraoperative Complications/etiology , Microsurgery/methods , Parathyroid Glands/surgery , Parathyroidectomy/adverse effects , Parathyroidectomy/methods , Rats , Rats, Wistar , Thyroid Gland/injuries , Tissue Adhesives/pharmacology , Treatment OutcomeABSTRACT
Quality of life of 89 patients with diffuse toxic goiter was analyzed before surgical intervention and at different terms after thyroidectomy or terminal subtotal resection of the thyroid gland using questionnaire SF-36. It was found that quality of life of patients with diffuse toxic goiter was lower than that of respondents without such pathology. The indices of quality of life one year after thyroidectomy (terminal subtotal resection of the thyroid gland) remained depending on the duration of the disease and complications of thyrotoxicosis, became reliably larger as compared with preoperative level due to social activity and emotional state.
Subject(s)
Graves Disease/surgery , Quality of Life , Sickness Impact Profile , Thyroid Gland/surgery , Thyroidectomy , Adult , Age Factors , Aged , Female , Graves Disease/complications , Graves Disease/metabolism , Graves Disease/pathology , Health Status , Humans , Male , Middle Aged , Postoperative Complications/physiopathology , Postoperative Complications/psychology , Postoperative Period , Preoperative Period , Surveys and Questionnaires , Thyroid Gland/pathology , Thyroid Hormones/metabolism , Thyroidectomy/adverse effects , Thyroidectomy/methods , Thyrotoxicosis/etiology , Thyrotoxicosis/metabolism , Thyrotoxicosis/psychology , Treatment OutcomeABSTRACT
Specific manifestations of postoperative laryngeal paresis observed with the use of indirect laryngoscopy are described in 53 patients subjected to the surgical treatment of diffuse toxic goiter. Laryngeal paresis was shown to develop both in the early (up to 7 days) and in the late (over 14 days) postoperative periods. The delayed form of pathology accounted for 13% of the total number of the cases of postoperative laryngeal paresis. The standard treatment of transient postoperative laryngeal paresis resulted in the complete recovery of vocal cord mobility within 1-6 months after the onset of therapy, regardless of the state of the cords at the time of diagnosis of the disease. Persistent postoperative laryngeal paresis developed by the end of the 15 month observation period. Phonation was found to be preserved in 66% of the patients in whom laryngeal paresis (unilateral abduction paresis) had been diagnosed by indirect laryngoscopy. In all the remaining patients, phonation recovered 15 months or more after surgery. The authors argue that neither the recovery nor the preservation of phonation can be a criterion for the absence of complications. Also, the outcome of surgical intervention unsupported by the results of laryngoscopy performed within 1, 6, and 15 months after the treatment does not reflect the true structure of postoperative complications.
