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.
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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