Professors Constantin and Gheorghe Țîbîrnă: promoters of personalized surgery of thyroid cancer

For 40 years (1980-2020) in the Department of tumor of Head and Neck Surgery of the Oncological Institute of the Republic of Moldova, the Clinic University „N. Testemitanu” were treated 18549 of patients with nodular pathology of the thyroid gland – which 6183 treated with cancer. It should be noted that 12366 were precancerous conditions: adenomas – 7296 (59%), toxic nodular goiter 2226 (18%), autoimmune thyroiditis (Hashimoto) – 2844 (23%), 1078 werechildren, 105 (9.7 %) with cancer.The incidence of thyroid cancer increased for about 4 times, in 1980 – 70 of patients (1.7%ooo), in 2020 – 294 of patients (8.3%ooo). The incidence of mortality was stabilized: 1980 -0.4%ooo), 2020 – 0.6%ooo). The incidence of prevalence was increased by 17 times, 1980 – 6.4%ooo), 2020 – 120.5%ooo).Depending on the sex, thyroid cancer was on average in women – 87%, in men 13%, the ratio being 9:1. How to explain the higher incidence of thyroid disease in women:In the hormonal activity in women, there are considerable physiological fluctuations during the life (puberty, menstrual cycle, pregnancy, births, abortions, climacteric involution, etc.). As a result, of hormonal disordes lead to some thyroid pathology, which is one of the most labile hormonal glands.Molfologically we mention that the first is papillary cancer (55.5%), in second – folliculary (32.8%), third – medullary cancer (7.8%), last one – undifferentiated (3.9%).Three types of surgery have been developed in the treatment of thyroid cancer: typical surgery, extended and combined surgery.Professors Constantin and Gheorghe Țîbîrnă from the typical operation are elaborated and implemented the operation–maximal subtotal resection of the thyroid gland with transplantation of the parathyroid glands with the vascular bundle in the sterno-cleido-mastoid muscle.From atypical operation, together with professor Nicolae Gladun, he is developed a surgery. Combined thyrodectomy with sternotomy, and paratracheal, mediastinal, anterior and posterior lymph nodes removed (T4b).