[The pathogenetic and clinical grounds for the advantages of nondrug procedures in the preoperative preparation of patients with diffuse toxic goiter].

An analysis of 615 patients operated upon for diffuse toxic goiter is presented. In 148 of them (24%) preoperative preparation was made with the help of nonmedicamental methods (extracorporal hemosorption, hyperbaric oxygenation (HBO), plasmapheresis). The state of euthyroidism was controlled according to their clinical symptoms and was verified by radioimmunological studies of triiodothyronine (T3), thyroxin (T4), thyrotropine (TTG). Indicators of corticosteroid hormones, thyrostimulating antibodies, antigenic HLA structure and antioxidative activity of different media of blood were also determined. The estimation of the data obtained as compared with results of morphological examinations allowed a conclusion that the above nonmedicamental methods in patients with diffuse toxic goiter are pathogenetically substantiated. Clinical expedience of their use is obvious. No lethal outcomes or complications resulted from using hemosorption and HBO. Single complications took place resulting immediately from catheterization of large venous vessels. Long-term results from 3 to 9 years have shown that recurrences of the disease in patients given nonmedicamental preoperative preparation were met much more rarely as compared with patients who obtained routine preparation (1.4% and 5.4 correspondingly).