[Experience of high frequency electric welding in endocrine surgery].

The comparative analsis of the effectiveness of surgical interventions performed by the standard method and using electric welding technology in endocrine surgery was hold. Compared duration of surgery, amount of intraoperatve blood loss, frequency of intra- and early postoperative complications. Found that the use of weding technology ensures shorter duration of surgery, on average by 30%, amount of blood loss--by 20-50%, the frequency of intra- and early postoperative complications.

[Clinical and epidemiological aspects of medullary thyroid carcinoma in Ukraine].

Analyzed data from 232 patients with medullary thyroid carcinoma who were treated in the surgical department of the Institute from 1979 to 2012 (inclusive). Found that the analyzed cohort of patients to meet other samples in such characteristics as age of patients and the distribution of the forms of the disease (sporadic, familial, in the syndrome MEN-2B). At the same time it is shown that the number of patients with sporadic medullary carcinoma from the end of the century the alien has increased significantly mainly due to the increase in the number of female patients. Analysis of the distribution of patients in the community shows that the share of the 5 most industrially polluted regions of Ukraine--Donetsk, Dnepropetrovsk, Lugansk, Zaporozhye, Kiev (and Kiev)--more than a third of patients with the sporadic form of medullary carcinoma of the cohort of patients, whereas in share of the best "clean" areas--Chernivtsi, Rivne, Volyn, Ternopil and Zhytomyr--3.6 times less. While noting some patients most of the areas most affected by the Chernobyl accident. The increase in the last decade the number of patients with sporadic medullary thyroid carcinoma, and more than the other samples, the number of female patients showed some features of the causes of this form of the disease among the population of Ukraine and can be due to the adverse impact of environmental factors, especially the female body.

[Recurrent malignant tumors of the adrenal glands: treatment and prognosis]. / Retsydyvni zloiakisni pukhlyny nadnyrkovykh zaloz: likuvannia i prohnoz.

The malignant adrenal tumors (MAT) have aggressive trend and inclined to often recurrences and early metastasis. The author has analyzed the causes of the recurrences of MAT in 292 patients which have been treated in the clinic. The recurrences of MAT were shown to originate rather from adrenal cortex than from adrenal medulla. The anaplastic and low-grade differentiated cancers associate with the worst prognosis and low efficacy of treatment. Regional lymphatic collectors were the most often observed localization of the recurrent tumor (63.5%). The development of new surgical procedures which include prophylactic systematic cellular retroperitoneal dissection will decrease the number of MAT recurrences after the primary surgical operation. The tumor recurrence is a bad prognostic factor. The patients (55.8%) with MAT recurrence were diagnosed to have their tumor incurable.

[Analysis of local lymphogenic spreading of malignant adrenal tumors]. / Analiz shliakhiv lokal'noho limfohennoho poshyrennia zloiakisnykh pukhlyn nadnyrkovykh zaloz.

The effectivity of the treatment of malignant adrenal tumors (MAT) depends on primary complete tumor resection with its regional metastases (RM). The possible regional metastases of malignant adrenal tumors in 257 patients have been studied. One third of the patients were diagnosed with regional metastases. Practically, almost all the patients had malignant adrenal tumors metastasizing lymphogenically. It was noted that independently of the tumors' localisation, morphological structure, the regional metastases more often were found in lymph nodes of the renal hilus, paranephral and paraaortical cellular tissue. Consequently, lymph nodes of the renal hilus, paranephral and paraaortical cellular tissue as well as of back muscle should be revised during radical operations in patients with malignant adrenal tumors.

[Malignant tumors of the adrenal glands without hormonal activity]. / Zloiakisni pukhlyny nadnyrkovykh zaloz bez oznak hormonal'noï aktyvnosti.

An increase in number of silent adrenal tumors is being observed by frequently using computer tomography and other modern diagnostics. All these tumors have to be diagnosed for their malignancy potential and hormonal activity to perform timely and curative treatment. The author has analyzed the results of treatment of 90 patients with malignant non-hormone producing adrenal tumors. As for the adrenal incidentaloma, the decisive criteria of malignant nature and accordingly direct operation indication are tumor size, computer tomography and Magnetic Resonance Imaging data. Fine needle aspiration biopsy is justified for diagnostics in case of suspicion of metastases to adrenals. The single most effective method for the treatment of malignant adrenal tumors is an open retroperitoneal lumbotomical adrenalectomy.

[Analysis of the results in pheochromoblastoma treatment]. / Analiz rezul'tativ likuvannia feokhromoblastomy.

Results of operative treatment of 60 patients with pheochromoblastoma were analyzed. Surgical method of treatment is the most effective one. Lumbotomic extraperitoneal access is the method of choice. Oncological radicalism demands not only complete excision of primary tumor in sole capsule together with suprarenal gland, but also the revision of paranephral, paracaval and paraaortal cellule. Radical intervention with subsequent durable remission was performed in 38 (63.3%) of patients, also in 3 (5%) the remission was achieved after reintervention conduction. Two (3.3%) patients are living with persisting disease, which can be controlled easier using medicines, than before the operation. In 8 (13.3%) patients with the spread metastases revealed and they were directed to symptomatic therapy by their residence. The recurrence occurrence after primary operation performance is unfavorable prognostic feature: 55.8% of such patients were considered incurable. Operative treatment performed had guaranteed the disease remission achievement in 71.9% of patients.

[Chloditane therapy of adrenocortical cancer]. / Khlodytanoterapiia adrenokortykal'noho raku.

Adrenocortical cancer (ACC) is a rare and aggressive tumor often diagnosed at the late stage of its development. Treatment with adrenocorticotoxic drug chloditane has been applied decades, but in spite of this we see scrupulous investigations of using chloditane in a complex treatment of ACC be carried out. The author has analyzed the following schemes of chloditane use: in preoperative period, after the potentially radical and non-potentially radical surgery, for symptomatic treatment. The most effective scheme of chloditane use was shown to be that of using maximal tolerance dose of the medication constantly after a conducted radical operation. The use of chloditane is not obligatory after potentially radical operation in case the tumor is less than 7-8 cm.

[The surgical treatment of malignant adrenal chromaphinomas]. / Khirurhichne likuvannia zloiakisnoï khromafinomy nadnyrkovykh zaloz.

Pheochromoblastoma (PHB) is a tumor developing from adrenal medulla and characterized by severe course and high mortality level (15%). The severity of patients' state determined not only by presence of cancerous growth, but also due to catecholamine hyperproduction. The author has analyzed the results of surgical treatment of 60 patients with PHB, which were in surgical clinic during 1968-2002 y.y. The most effective method of the treatment is surgery. The method of choice is a lumbotomic extraperitoneal approach. The eradication of malignant growth requires not only complete tumor removal in single capsule with the adrenal gland but also thorough revision of paranephric, paracaval and paraaortal lymphnodes. 38 patients (63.3%) from 60 underwent radical surgery followed by long-term remission. The remission of the disease in 3 patients (5%) was achieved only after reoperations. The disease persists in two patients though it is better controlled after the operation than earlier with medicine. 8 (13.3%) patients were diagnosed to have widespred metastases and were referred to symptomatic treatment. The recurrence of the disease after the primary surgery is a bad forecasting factor. The majority of the patients (55.8%) with the recurrence were incurable. In the rest of the cases the operative treatment led to the longterm remission only in 71.9% of the patients.

[Features of clinical presentation of malignant adrenocortical tumor cortex metabolism over time]. / Osoblyvosti klinichnoho perebihu zloiakisnykh pukhlyn kirkovoï rechovyny nadnyrkovykh zalov.

Malignant adrenocortical tumors is serious oncological pathology, which without early diagnosis and radical, first of all, surgical treatment leads to death. The authors have analyzed the treatment results of 216 patients with adrenocortical carcinomas, which were in clinic during 1968-2002. The tumors were 32.6% of all adrenal tumors. Most of the tumors were hormone-active. The best results were obtained with performing primary radical surgery at the early stages (without appearing of regional metastasis). The performing of reoperations in majority of cases guarantees the remission of disease, but seldom could be radical. The use of chloditan makes longer the survival level, but in the bulk of cases chloditan used as an additional curative method.

[The application of radiosurgical methods in the treatment complex of Itsenko-Cushing disease]. / Zastosuvannia renthenokhirurhichnykh metodiv u kompleksi likuvannia khvoroby Itsenko-Kushinha.

More then ten year follow up of 154 patients with Itsenko-Cushing disease (ICD) is presented, of whom in 69-one sided and in 89-bilateral transcatheteric transvenous adrenal glands destruction (TTAGD) was done. In 50% of them the remission of disease for a period of 5-10 years was observed.