Suvremene tehnologije u kirurgiji štitnjače

master's thesis

• Title (english): Modern technology in thyroid surgery
• Author: Rudolf Radojković
• Mentor: Drago Prgomet (mentor)
• Committee member: Srećko Branica (predsjednik povjerenstva)
• Committee member: Mario Bilić (član povjerenstva)
• Committee member: Drago Prgomet (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Štitnjača ili štitasta žlijezda ime je dobila po svom specifičnom obliku, obliku štita. Smještena je u donjem prednjem dijelu vrata, te se sastoji od 2 postranična režnja i središnjeg dijela koji ih spaja. U njoj se stvaraju hormoni (T3,T4), koji se krvlju raznose do svake stanice u ljudskom organizmu, gdje utječu na metaboličke procese svake. Poremećeno izlučivanje, prekomjerno ili smanjeno stvaranje hormona, kao i razni strukturalni poremećaji zahtijevaju liječenje, koje nerijetko završava kirurškim odstranjenjem dijela štitnjače (lobektomija) ili odstranjenjem štitne žlijezde u cijelosti. Najčešći razlog zbog kojeg izvodimo terapijske kirurške zahvate na štitnjači je prisutnost čvorova ili tumora u ili na samoj žlijezdi. Većina čvorova je benigna, ali neki mogu biti maligni ili prekancerogeni. Čak i benigni čvorovi mogu uzrokovati simptome ukoliko narastu toliko da dovedu do opstrukcije i kompresije ostalih organa smještenih u vratu, ili mogu uzrokovati funkcionalni poremećaj u smislu prekomjernog stvaranja i izlučivanja hormona štitnjače. Minimalno invazivna kirurgija vrata i štitnjače je jedna od najnovijih i najzanimljivijih metoda općenito. Posebno je interesantna zbog toga jer se, primjenjujući ovu metodu, mogu izbjeći neugledni ožiljci koje za sobom ostavljaju klasični operacijski postupci u predjelu vrata. Minimalno invazivni pristup se razvio u Europi i Aziji, odakle se proširio i usavršio u Sjevernoj Americi, gdje je predstavljen kao MIVAT- minimalno invazivna video-asistirana tiroidektomija. Glavna prednost ove metode nad klasičnim oblicima tiroidektomije su sigurnost zahvata, te minimalni estetski defekt, uz kraći postoperativni oporavak i kraću hospitalizaciju. Promatrajući sa te strane, možemo reći kako ovom metodom, možemo smanjiti boravak pacijenta u bolnici, čime smanjujemo i same troškove liječenja istog. Neki od nedostataka minimalno invazivne kirurgije su suženo operativno polje, nemogućnost palpacije tvorbe, te postojanje kontraindikacija kod određenog broja potencijalnih pacijenata. Ovaj oblik kirurgije zahtjeva edukaciju operatera i modernizaciju tehnologije u operacijskim dvoranama koji trenutno dijelom ograničavaju primjenu ove metode.

Abstract (english)

Thyroid gland was named after its specific form of the shield. It is located in the lower anterior part of the neck and consists of two lateral lobes and the central part which connects them. Thyroid gland produces hormones (T3, T4), which are transported through to every single cell in the human body, where they modulate metabolism. Disorder of secretion, excessive or reduced production, and other structural disorders require treatment, which often ends in a surgical removal of the part (lobectomy) or removal of the whole gland. The most common reason for the thyroid gland surgery is the presence of the nodes or tumour in, or on the surface of the gland. Most of the nodes are benign, but some of them could be malignant or pre-malignant. Even benign nodes could cause symptoms if they grow enough to obstruct or compress other organs located in the neck, nearby the gland, or they could induce functional disorder which is presented as an excessive production and excretion of the hormones. Minimally invasive neck and thyroid gland surgery are the most recent and the most interesting methods. It is especially interesting because, using this method, we can avoid ugly scars which remains after the classic surgery in the neck area. Minimally invasive surgery developed in Europe and Asia and, from there it expanded to North America where it improved and is presented as MIVAT- minimally invasive video-assisted thyroidectomy. Main advantages of this method over the classic forms of the thyroidectomy are the safety of procedure and minimal aesthetic defect, shorter post-operative recovery and shorter hospitalization. From this point of view, we can say that by this method we can reduce hospitalization time of patients, decreasing the amount of money spent on treatment. Disadvantages of this method are narrow operational field, impossibility of palpation, and there are some contraindications in some potential patients. This form of surgery requires education of the operator, modernization of the technology in an operation room which currently limits the use of this method.

• Keywords: štitnjača; anatomija; fiziologija; patologija; kirurgija; MIVAT
• Keywords (english): thyroid gland; anatomy; physiology; pathology; surgery; MIVAT
• Language: croatian
• URN:NBN: urn:nbn:hr:105:959746
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-16 11:35:00