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THE ESSENCE OF THE AUTOPLANTATION METHOD AND THE
IMPROVEMENT OF THE DIAGNOSTIC-TREATMENT ALGORITHM
OF DIFFUSE TOXIC BULLOCKS
Djalalov A.S.
Khakimov D.M.
Khamidov F.Sh.
Botirova D.R.
Andijan State Medical Institute, Uzbekistan
https://doi.org/10.5281/zenodo.13888569
Relevance and necessity of the topic.
A distinctive feature of the
transplantation of endocrine structures is the ability to transplant them in the
form of an entire organ, its fragment and even individual cells, which opens up
surgically easily accessible, free transplant Pathways [2;5]. Transplant methods
differ mainly in the place of introduction of thyroid tissue culture [3;6]. The most
effective transplant zone is not fully studied [5].
Th transplantation was
performed using autoallo and xenotransplantates. Experimental research on Th
auto transplantation has been ongoing for over 100 years [4;5]. There has been
an increased interest in thyroid tissue transplantation for those with
hypothyroidism. At the same time, the postoperative mortality rate remains
high, the cost of internship intervention is very high, long-term
immunosuppressive therapy is necessary, complications of immunosuppressive
and surgical nature reach 75% [1;2;7].
Thus, cell transplantation has proven its consistency, certain achievements
of endocrine cell transplantation and increased interest of clinicians in this
problem should contribute to significant progress in the treatment of endocrine
tyropathies.
The purpose of scientific research.
The essence of the auto plantation
method and the improvement of the diagnostic-treatment algorithm of diffuse
toxic throat.
Andijan State Medical Institute Y. Otabekov's Department of surgery III also
featured the medical history, operational journal data, and associated outpatient
cards of 263 patients who underwent diffuse toxic throat (DTB) surgery from
2010 to 2019. A retrospective assessment of 263 patients who had been treated
and left showed that 120 had been St tasrikhi performed, from which: 76 were
found to leave up to 1.0 gr in the thyroid seat, 30 to 1.1+2.0 gr, and 14 to 2.1+3.0
gr. Patients who underwent this ST surgery became known as Group 1.
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In 65 patients after 1.263 patients, an additional cut-off 1,0-gram gland
autotransplantate was planted over the subtotal thyreoidectomy tasrix. These
were left in 41 of the 1.0 gr. on the gland +1,0 + 2,0 gr. autotransplantat, 1.1+2.0
gr left in 13 persons. on the gland +1,0 + 2,0 gr. autotransplantat, 2.1+3.0 gr left
in 11 persons. on the gland +1,0 + 2,0 gr. autotransplantat is planted with
glandular tissue. We have designated patients with this subtotal thyreoidectomy
+ performed as Group 2.
In 78 patients after 263 patients, total thyreoidectomy was isolated from
under the gland by attaching a silky thread knot with an uninterrupted
connection in addition to the tasrix, but not separated from the glandular base.
That is, up to +1.0 gr over the node (n=51), up to 1.1+2.0 gr (n=15), up to 2.1+3.0
gr (N=12) left the patient untouched in the glandular seat without extension.
Total thyreoidectomy was referred to as glandular Autoplant leaving Group 3
(TTAP) in conjunction with the transfer.
Between 2010 and 2019, when we divided 263 patients who had diffuse toxic
throat surgery into women and men: 228 (86.7%) were women and 35 (13.3%)
were men and 7:1 ratio when women were men. Enlargement of the thyroid
gland at Level II-19 (7.2%) individuals, enlargement at Level III – 124 (47.1%)
individuals, enlargement at Level IV-92 (35%) individuals, and Enlargement at
Level V – 28 (10.6%) patients. It was noted from the table that the largest
number of patients applied with an increase in Level III and Level IV.
Research methods.
The complaints and medical history of the 263 patients who applied were
thoroughly studied, the following examination methods were used.
Clinical objective and subjective examinations were carried out in 263
patients (examination, palpation).
Instrumental examinations: ultrasound examination (UTT) and
electrocardio-gram (ECG) were used in 263 patients.
Biochemical analyzes: an examination of serum "cholesterol" levels was
carried out in 242 patients. Total serum calcium(Ca+) levels as well as those in
the forehead were tested in 263 patients and phosphorus(r+) levels were tested
in 12 patients.
Radioimmunological tests: T3, T4, TTG, anti-TPO, anti-TGS were tested in
225 patients, paratgormoni-in 3 patients.
Contrast computed tomography: performed in 36 patients with the aim of
examining the cervical, spinal, spinal and thoracic Sox.
58 patients with thin needle puncture biopsy (IIPB) were examined in an
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outpatient manner.
Postoperative hysto-pathomorphological testing was performed in 263
patients.
Statistical analysis. The results from the checks were used in the calculation
of the "Excel" program and reliable differences in the WINDOWS_XP
environment, the T – criterion of the Styudent. The comparative difference
between the groups was checked by the magnitude of the Styudent criterion p-
E-0.05, p-e-0.01, p-e-0.001.
Results and references.
The essence of the autoplantation method. The
concept of an Autoplant is to leave an untouched non-elongate Autoplant in the
glandular seat in the hole, which separates the thyroid tissue from its location by
a nodular suture. Out of the 78 patients who performed Total thyreoidectomy,
51 were left with an autoplant of +1.0 gr over the node. 15 were left with an
autoplant between 1.1 gr and+2.0 gr over the node.
12 were left with 2.1 gr to +
3.0 gr of autoplant tissue over the node, and a total thyreoidectomy operation
was performed with a cut over it. The fact that the gland itself was rich in blood
vessels, while the tissue of the fascia was also rich in blood vessels, caused
Shyevkunenko's fascia to be re-wrapped over the autoplant and sutured and
fixated. In order to regenerate the Autoplant, a knot was formed beneath the
thyroid gland itself and a bandage was formed over it by fascia. But remains
stuck with the top side, which is attached to the fascia. Even if the Autoplant is
isolated for a certain time, after fixation, soon (from 1 week to 6 months)
collagen fibers in the fascia grow into the follicles-aro of the Autoplant together
with blood vessels. Collagen fibers and blood vessels entering the Autoplant
parenchyma capture the transplant. From under the gland Autoplant – over the
trahea plates, fastsial collagen fibers are pinched with a nodular suture, so that
the tissue between them is absorbed in 7-8 days. With an Autoplant, the trahea
plate is isolated from one another. As a result, the autoplant from the base of the
gland becomes lonely. During this period (1-6 months), the disconnected
autoplant can also shrink to a certain part or be completely absorbed. A large
amount of T3–T4 hormones, which are absorbed into the blood through the
thyroid tissue, are synthesized during this period and destroyed at the end of the
term, the amount of T3–T4 hormones in the blood is normalized or reduced. The
fascia, where the upper surface of some areas of Autoplant tissue that have been
left unabsorbed, is fused with the blood vessels, meaning that blood vessels
grow into the autoplant parenchyma and activate the plantation. Applying laser
light to plant tissue remaining on the surface of the trachea also leads to
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reparative regeneration of the glandular tissue and plant. The development of
the plantation can lead to recurrence of DTB in some cases, the development and
duration of weight levels, and functional and morphometric changes in tissue. In
the postoperative period, the absorbed and non-absorbed part of the Autoplant
leads to regeneration and stimulation of its function. Thyreoid complements
hormone deficiency. That is, failure is prevented by this reserve until the base of
the thyroid gland completely compensates the div. Saturates the deficits with
calcium elements. The Autoplant prevents itself from being stimulated by TTG.
Improvement of the diagnostic-treatment algorithm for diffuse toxic bull.
And the methods of examination that we apply and offer, firstly, there are a lot of
clinics, and in business activities, and secondly, to show the DTB every clinical
signs, there are opportunities in the apparatus in which this is being applied.
One is used even when applied from the device or is forgotten without
application. Fourth, hyperdiagnostics or hypodiagnostics should not be allowed.
From the fifth to the surgery, hypodiagnostics are performed and the surgery is
followed by another diagnosis on a histo-morphological examination. An
operation with this will not be advisable. From the sixth, TPO-antibodies, Tg-
antibodies, TTG-antibodies were included in further investigations to this day,
since these investigations were considered as predictors of complications. In
addition to other Hech which complications of a disease are not as common as
DTB disease. To avoid complications after the operation, TPO-antithela Tg-
antithela was included among the main examinations, similar to hormonal
examinations of TTG-antitheles. Seventh, the improved operation that we are
staying with has led to a significant reduction in complications. For this reason,
it was considered desirable to bring into the algorithm layout. The eighth
consists of monitoring, taxing and monitoring the quality of the patient's life, of
course, long-term results after long-term and ongoing operations. Hence, the
diagnostic-treatment algorithm for diffuse toxic Bull: this-retrospective results
were considered to increase the effectiveness of treatment under diagnostic
improvement.
Conclusion.
So, in the process of our scientific and practical work, we have
improved the essence of the autoplantation method and the diagnostic-
treatment algorithm for diffuse toxic Bull, which has led to an improvement in
the results of treatment by sugary.
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Lukavetsky O.V. //Asta Medica Leopoliencia. -1999. -N 2. -Item241.
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Boyko N.I. Allotransplantation of pancreatic islet cell cultures in surgical
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