3D- SIMULATION AS THE METHOD OF TOPICAL DIAGNOSTICS IN THE SURGICAL TREATMENT OF GIPERPARATIREOZA

Autor: V V Zhirov, Igor V. Makarov, A Y Sidorov, R A Galkin, AV V Kolsanov
Rok vydání: 2019
Předmět:
Zdroj: Bulletin of the Russian Military Medical Academy. 21:81-84
ISSN: 2687-1424
1682-7392
DOI: 10.17816/brmma13052
Popis: Urgency of theme. Morbidity by primary giperparatireozom (PGPT) varies from 0,4 to 18,8 the cases for 10000 the populations. Defeat the parathyroid glands in patients with second (VGPT) and tertiary (TGPT) giperparatireozom, who are found on program hemodialysis reaches 32-34%. The only method of treatment is surgical. The effectiveness of operational interference in many respects depends on verification and visualization of all the pathologically changed parathyroid glands. Purpose. To improve topical diagnostics of parathyroid adenomas by constructing the personified preoperation 3d-model of the anatomical formations of neck on basis MRT. Materials and methods. Preoperation 3d-simulation is executed 10 to the patients: 3 by patient with PGPT, 7 patient with TGPT. For obtaining the personified 3d-model were used results MRT and special software (priority information №2018122324, also, 2018122326 from 18.06.2018). In the regime of preoperation planning were built the three-dimensional models of neck with the designation of trachea, the thyroid gland, the parathyroid glands, gullet, collar bones. Obtained results. With the use of preoperation 3d-simulation it was possible to avoid diagnostic eksploratsii of neck in search of not less 4th parathyroid glands, was reduced the time of the fulfillment of operational interference on the average on 30±15 minutes, was possible to avoid the postoperative complications, connected with the damage of recurrent guttural nerves. Conclusion. The method proposed is the reliable method of pre-operation topical diagnostics of pathologically changed parathyroid glands. With the use of 3d-simulation the operation time decreases, is reduced the need for traumatic and expensive on the time eksploratsii of neck, necessary for the search for changed parathyroid glands, and, correspondingly, the probability of the development of postoperative complications. This method can serve as the objective criterion of visualization parathyroid glands and also as the criterion of effectiveness of the carried out treatment
Databáze: OpenAIRE
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