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  Česky / Czech version Prakt. Lék., 2005, 85, No. 5, p. 293-296.
 
Indications for surgical intervention in thyropathies  
VLASÁK V., JAROŠEK J., TOMKOVÁ M. 

Chirurgické oddělení ÚVN, Praha, přednosta pplk. prof. MUDr. M. Ryska, CSc.
 


Summary:

       On the basis of many-year surgical experience with thyropathies, in collaboration with endocrinologists and other participating experts the authors present their own nine-year series (1995-2003). During that period the opinion on radical intervention in the separate types of thyropathy has been changing. Graduaily, sub-total resections of the thyroid gland háve been abandoned, so that at present, in agreement with endocrinologists, most frequently there are performed more radical surgeries - TTE, nTTE, TL, and nTL. Valid is the principle that all patients with thyropathies operated on, háve to be under life-long dispensary care and endocrinological treatment, námely under substitution therapy that has been previously a prevention of recurring thyropathies in subtotal resection. Endocrinologists carry out dispensary examinations once to twice a year, in the meanwhile the patients are in the care of family physicians who prescribe medication. There háve also been changing the surgical proceduře in the sense that in more radical Ínterventions there is now being carried out the identification of n. recurrens and the para-thyroid glands. In as it is well known that there is almost zero mortality in thyroid surgery, there has also been graduaily shortened post-operati-on hospitalization. Although in the USA thyropathy surgery has been included in the group treated under the regimen of „one day surgery", on the basis of our own experience we are of the opinion that in our con-ditions that would threaten the patients operated on, and that has been confirmed by reports from other centrál European facilities. The grounds for that may be delayed hemorrhage in the matrix at the site of thyroi-dectomy with compression of the trachea.

        Key words: indication for surgery of thyropathies - radicalness of surgical intervention - shortening of post-operation hospitalization
       

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