Recently, there has been an increase in endocrine diseases all over the world. The most common are diabetes mellitus and thyroid disease. According to doctors, endocrine diseases can be acute or chronic and in some cases pose a threat to human life.
Today, there is a high frequency of thyroid diseases among the female population of various ages and regions of thymus endemic. Among all diseases of the thyroid gland, the most common are the nodular forms of goiter, which is primarily associated with iodine deficiency in the biosphere and the unfavorable environmental situation in our country.
There are more than a dozen diseases of the thyroid gland, but the most common are goiters – euthyroid (endemic and sporadic) and toxic (thyrotoxicosis or “Graves”), hypothyroidism and inflammatory processes. The main place in this pathology is occupied by the nodular forms of goiter. And recently, cancers of this endocrine organ have become more frequent.
According to various specialists, thyroid pathology is in fifth place in terms of prevalence among other chronic pathologies, about 50% of the population have problems with the thyroid gland.
The known treatments are not completely effective. The most costly and aggressive is surgical intervention, which is indicated for certain forms of nodular goiter. It is associated with the patient’s stay in the hospital, anesthesia, surgical incision and postoperative scar on the neck, and, ultimately, the “loss” of at least one lobe of the thyroid gland. To date, it has become possible to cure this disease with a less aggressive, minimally invasive method.
The medical center “Vita Sana”, which is located on the basis of the Ternopil City Clinical Emergency Hospital (2 Gospitalnaya St., 3rd floor) for the first time in Ukraine, offers a worthy alternative to surgery – non-operative treatment of diseases of the thyroid gland, subcutaneous fat base with a new minimally invasive, highly effective method laser-induced interstitial thermotherapy (LITT), which is based on the therapeutic effect of a diode laser on the affected tissue area. The manipulation is carried out on an outpatient basis, does not require special training, does not change the rhythm of his life habitual for the patient. Treatment and, in the future, dynamic observation and ultrasound control are carried out by highly qualified specialists.
In the 1980s, laser-induced interstitial thermotherapy was only available for the treatment of the upper echelons of society. In 1996, the method of laser-induced interstitial thermotherapy was introduced into mass use and today it is used in leading clinics in the USA, Italy, Australia, Japan, Russia and other countries. During this period, many publications have accumulated on the therapeutic possibilities of laser radiation, its effect on living tissue has been widely studied and the long-term results of treatment have been studied.
Treatment of thyroid pathology using the minimally invasive method of laser-induced interstitial thermotherapy is individual. However, in spite of the patient’s pathology, doctors of Vita Sana recommend that all patients do an ultrasound of the thyroid gland and, in the presence of a tumor (node), a fine-needle aspiration targeted puncture biopsy (TAPPB) is mandatory, in order to accurately determine existing disease and establish the correct diagnosis.
Among the diseases of the thyroid gland, the more common: diffuse euthyroid goiter, diffuse toxic goiter, nodular euthyroid goiter, nodular toxic goiter, multinodular euthyroid goiter, multinodular toxic goiter, nodular goiter with cystic degeneration of nodes, hypothyroidism, autoimmune thyroiditis, and a combination of these pathologies is also possible in this case, a mixed goiter is diagnosed.
Considering the issue of nodular goiter, one should pay attention to the fact that there are cases of thyroid nodules and nodules with cystic degeneration, the so-called thyroid cysts. These formations usually have a capsule that contains blood vessels and nerve endings that feed the tumor.
There are many treatments for this pathology. They can be divided into conservative (hormonal drugs, nutritional supplements, resorption therapy, iodine preparations, etc.) and invasive (surgical treatment, laser-induced interstitial thermotherapy, sclerotherapy). However, according to the latest research, conservative methods in the treatment of nodular goiter are ineffective or ineffective.
So, the method of choice of treatment remains: surgery, laser-induced interstitial thermotherapy and sclerotherapy. Each of them should begin with a cytological examination: under ultrasound control, a small group of cells of the node itself is taken and examined under a microscope, in addition, the level of thyroid hormones is determined. After the results of the research, the question of the method of treating this disease is decided.
Laser-Induced Interstitial Thermotherapy (LITT)
This method is based on the application of the combined action of light and temperature at the end of a fiber that is inserted into the tumor itself. A temperature of 41 – 46 ° is used, and a power of 2.8 – 3.2 W, which affects the protein structures of the cell, without destroying it as a whole, but further division of the latter becomes impossible. Due to the fact that the nodes of the thyroid gland are supplied with blood through the capsule, the temperature that is created in the node does not extend beyond its capsule, since in this case the blood serves as a cooling liquid. Therefore, the treatment is carried out only for the node, the temperature of the surrounding tissue does not change, this has been proven by scientific experiments. After a while, the tissue of the node gradually decreases and is replaced by connective tissue, an “internal” scar, which poses no threat either to the thyroid gland or to the body as a whole. In the case of a node with cystic degeneration (thyroid cyst), treatment is carried out in two stages. The first stage is the treatment of the actual cystic transformation by the method of sclerotherapy. The basis of this method is that under ultrasound control, the liquid part of the node is removed (aspirated) and a medicine (sclerosing solution) is injected into the cavity that has formed for a certain time. As a result of such manipulations, the cells that secreted fluid into the node lose the ability to do this. After treatment, the patient is observed for some time and when the node ceases to produce fluid, the second stage of treatment is carried out using the method of laser-induced interstitial thermotherapy. All manipulations are carried out only under ultrasound control and with strict adherence to sterility.
Benefits of interstitial thermotherapy:
- The manipulation is carried out on an outpatient basis (the patient does not need to change his style of daily life);
- The procedure does not require special training;
- Anesthesia is not performed;
- Surgery is not performed;
- No deforming postoperative scars;
- The absence of possible specific postoperative complications (damage to the vocal nerves or thyroid glands);
- The thyroid gland is preserved, as well as its function.
Indications for the use of the method (LITT):
- Nodular goiter (with normal, increased, or decreased thyroid function)
- Adenoma with functional autonomy
- Polydose goiter (with normal, increased, or decreased thyroid function)
- Autoimmune thyroiditis
- Diffuse goiter (with unchanged or increased function)
Contraindications to the use of the method (LITT):
Contraindications to this technique can be divided into:
and. Absolute.
b. Relative.
There are no absolute contraindications to the use of laser-induced thermotherapy in the treatment of patients with thyroid diseases.
Relative contraindications:
- severe forms of thyrotoxicosis or hypothyroidism in the stage of decompensation;
- multiple nodal changes in the thyroid parenchyma;
- mental illness;
- somatic diseases in acute form;
- inflammatory diseases of the upper respiratory tract in the acute period.
Conclusions:
- According to the technology of implementation, laser-induced interstitial thermotherapy allows to act only on the tissue of the node and is a highly effective method of treating functional autonomy on the basis of the nodular goiter.
- Laser-induced interstitial thermotherapy of thyroid nodules allows preserving the parenchyma of the gland and avoiding the development of hypothyroidism.
- Laser-induced interstitial thermotherapy is a safe and highly effective method of treating patients with nodular toxic goiter of thyrotoxic cardiomyopathy complicated by atrial fibrillation and heart failure.
Thyroid disease has been around for many years and is quite common among the female population. Diseases can be acute and chronic, and sometimes they can be fatal. This organ helps in the production of hormones for life.
Thyroid value:
- reproductive mission;
- exercises control over fat, protein, carbohydrate balance;
- control of the development and growth of tissues and organs;
- helps in the normal functioning of the nervous system.
The main cause of the disease is not enough iodine in the body. And due to it, some hormones are produced. The doctor chooses the therapy purely individually. It is very important not to quit treatment and see a specialist in a timely manner .
Nodular goiter and malignant tumor are common indications for thyroid surgery. The procedure is dangerous and can be accompanied by many complications, therefore, it is prescribed by doctors only after a thorough examination.