As a result of studying the dynamics of the incidence of laryngeal cancer in the Republic of Moldova, in the period from 1980 to 2020. It was found that annually, a malignant tumor of the larynx, on average, about 120 patients fall ill. Over the course of 40 years, 874 patients were identified, of which more than 80% were admitted for treatment at stages 3-4 of the disease. This article studied the results of surgical treatment of 258 patients with locally advanced laryngeal cancer. Based on the characteristics of the spread of laryngeal cancer to neighboring organs and tissues, they gave us the basis to distinguish five main types of surgical intervention: upper, lower, anterior, posterior and lateral. The justification of these operations is proved by the patient’s life expectancy, which is 53.6%.
Peculiarities of individual mini-invasive surgery in the surgical treatment of nodular pathology of the thyroid gland in children. During 40 years in the clinic „Surgery of tumors of the head and neck region” of the Oncological Institute of Republic of Moldova were treated 18549 patients with thyroid nodular pathologies, of which 1078 were children. 105 (9,7%) children were diagnosed with thyroid cancer, 534 (49,5%) – with adenomas, 213 (19,7%) – with toxic nodular goiter, 226 (21%) – with Hashimoto’s stroke. The ratio of affecting girls / boys 6: 1, the most vulnerable age – 9-16 years. The most common morphological forms were papillary and follicular cancer 97 children (92,3%). During 2020, the method of mini-invasive organ-threatening operations in children with thyroid nodular processes was implemented. The main advantages of mini-invasive operations are the following:Intraoperative safety The small cost Minimal postoperative complications.
Minimally invasive thyroid surgery is a relatively new branch that has begun to develop since the 1990s, it comes in response to an increasing incidence in recent decades of thyroid tumors such as cancers and adenomas. Thin minimally invasive thyroid surgery has 2 main directions: with and without approach in the neck region, and those with approach at the neck are divided into endoscopic and non-endoscopic. Miniinvasive interventions have a number of advantages over the classic ones such as reduction of postoperative pain syndrome and analgesic consumption, respectively, shorter residence time and much better cosmetic results. Not all patients with thyroid tumors can be operated minimally invasively, there are a number of selection criteria: early stage of primary thyroid cancer or adenomas smaller than 3.5 cm in diameter, without capsule penetration or metastases, the volume of the gland should not exceed 50 -60 ml are not allowed overweight patients, patients with severe chronic morbidity, patients with a history of surgery on the neck, patients as short as possible, children and the elderly are not allowed too
The idea of the paper from the state scientific program under the name „Modern personalized surgery in the diagnosis and complex treatment of tumors in children”. In the first stage, the executors conducted statistical research on the incidence of thyroid cancer in children. During 40 years from 18549 cases of nodular thyroid pathology, 1078 cases were detected at children: 105 - (9.7%) with cancer, adenomas 534 (49.5%), toxic nodular goiter 213 (19.7%) , struma Hashimoto 226 (21%),: ratio girl : boys 6: 1. The most affected age is 9-16 years. The highest morbidity is in children aged from 12 to 15 years.The morphological structure of thyroid cancer in children (105 patients) was as follows: first - papillary cancer - 68.6%, the second follicular cancer 23.8%, the third medullary cancer - 5.7% and the fourth anaplastic cancer - 1.9%.The priority goal of the authors was personalized medicine, which involves selecting an appropriate treatment for the patient, depending on the volume of the primary tumor, the morphological type and the biological evolution of the tumor. In the diagnostic plan for the assessment of tumor aggression, the authors will propose immunohistochemical research in assessing the angioinvasive aggression of thyroid carcinomas in children. It is proposed to investigate the expression of thyroiglobulin, keratin and vimentin, peroxidase. Peroxidase expression was studied in 22 children. Thyroglobulin expression was studied in 31 children. And the expression of keratin and vimentin was studied in 16 children [2, 4-6].
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