INTRAOPERATIVE AND PERIOPERATIVE SAFETY IN ENDOCRINE SURGERY

Aim. To modernize the system of intraoperative and perioperative safety in endocrine surgery. Materials and methods. Experience of treating 5350 patients with thyroid pathology, 41 – with hyperparathyroidism and 53 – with adrenal diseases using the system of intraoperative and perioperative safety is presented in the paper. Results. Complex method of preoperative preparation of patients, sparing bloodless technique allowed to decrease the number of the postoperative hemorrhages among patients with thyrotoxicosis to 0,4%, hypoparathyrosis – to 1,3%, damaged recurrent nerve – to 0,5%, thyrotoxic reactions – to 1,8%, to reduce the period of hospitalization to 4–5 days, to reach favorable functional and cosmetic results. In patients operated for hyperparathyrosis, no complications were fixed. According to retrospective investigation, calcium metabolism stabilized by the 3 rd week after the operation and was preserved during all the follow-up period. Conclusion. Safety of endocrine surgery is provided by precise determination of indications to the surgery, adequate preoperative examination and preparation to the surgery, rational operative intervention and postoperative follow-up observation. Application of the developed system of intraoperative and perioperative safety permitted to shorten the period of preoperative preparation, to decrease duration of operative intervention and the number of complications. Safety system is effective in the presence of “closed” cycle of treatment including out-patient reception, endocrinological unit, surgical clinic, resuscitation and intensive care unit, postoperative observation by endocrinologist and operating surgeon.