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Subtotal thyroid resection

Thyroid resection is an operation in which part of the thyroid gland is removed. In this case, it is possible to cut one or both lobes of the organ, but a small amount of tissue is left. At present, such operations are performed less frequently, since scars and scars often remain at the incision site, and repeated surgical intervention can lead to various complications.

Subtotal resection of the thyroid gland is a surgical operation that aims to remove the main part of the organ. There are times when it is necessary to remove both lobes of the thyroid gland. During the procedure, the surgeon preserves parts of tissues whose mass is less than 6 grams of the original weight of the lobes. Postoperative rehabilitation is the passage of therapy with L-thyroxine.

Surgical treatment is prescribed only in the presence of serious pathologies. First of all, surgery is necessary for patients with adenoma. Indeed, with this disease, the only method of treatment is surgery. Also, the operation is indicated for thyroid cancer, for malignant tumors, in the presence of nodes and their increase by more than half a centimeter in six months.

Subtotal resection of the thyroid has been used in medicine for a long time, because this method is one of the most effective in the fight against thyroid diseases.

Preparation for resection

An operation can only be prescribed if the patient has no exacerbation of chronic diseases and his health condition is satisfactory. About 3-6 months before the resection, the patient should receive thionamides.

In about a week, iodides are prescribed. This is necessary to reduce the volume of blood that enters the thyroid gland. You can also prepare for the operation by another method. In this case, a short course of blockers in large doses is prescribed. In this case, thionamides are not prescribed. These blockers normalize the heart without affecting catabolism. This method is recommended for mild thyrotoxicosis in the patient and if he does not tolerate thionamides.

Operation

Thyroid resection involves several stages. First of all, an ultrasound examination should be prescribed, which is performed by the operating surgeon. With the help of this examination, it is possible to identify the location of the structure of the organ, the location of the tumor, the state of the lymph nodes. Next, the doctor makes a markup on the skin where the incision will be made.

After that, the anesthetist puts the patient into a medical sleep, and the doctor proceeds to cut the skin according to the marking. It is worth noting that the size of the incision depends solely on the type of disease and the size of the thyroid gland. This should be discussed with your doctor in advance. The average cut size is 2-12 centimeters. If the thyroid gland is removed completely, then the dissection length will be as long as possible. Next, the doctor removes the affected area of ​​the thyroid gland or the entire organ completely. If the neoplasm is too large, then the allocation of the thyroid gland is carried out with the intersection of the neck muscles (short). Most often, the intersection is not applied, so the patient almost does not feel pain after surgery. This helps reduce puffiness and speedy return of mobility.

Next, the doctor makes a ligation and intersection of blood vessels. This is necessary in order to prevent injury to the outer branch of the upper nerves of the larynx. After this, the recurrent nerve and the parathyroid gland are secreted. It is worth noting that the circulation of the thyroid gland is preserved. Next, part of the gland is removed. The surgeon must bandage the blood vessels, and then remove the thyroid lobe.

If there is evidence, the second lobe of the gland is removed. The removal scheme is similar to the removal of part of the thyroid gland.

In addition, lymph node dissection is performed. This is the removal of lymph nodes and fiber. Most often, surgeons prefer central lymphatic dissection. If metastases are detected in certain places, then lateral lymphatic dissection is necessary. After that, the neck muscles are stitched and drainage is put. With its help, the remains of blood are removed. Next, cosmetic stitches are applied. Most often this is carried out using material that does not absorb. In this case, the suture is removed after wound healing. Also, absorbable material is used. Then the removal of the seam is not required. In these cases, specially designed adhesive may be used.

Postoperative period

Modern medicine involves operations on the thyroid gland, which go without complications. The patient recovers rather quickly and it is not necessary to be in the hospital for too long. Nevertheless, there is a chance of complications. After subtotal resection of the thyroid gland, the patient may experience hoarseness. This can be due to damage to the larynx nerve. It is worth noting that such a complication occurs in 1-2 cases out of a hundred. This is explained by the fact that surgeons can not always notice the injury of the larynx nerve in time during the operation. If the injury was bilateral, then paralysis of the vocal cords can occur. Such serious complications are very rare.

It is also possible postoperative bleeding in case of a sharp increase in blood pressure. Such an unpleasant phenomenon is rare and usually manifests itself within 12 hours after the resection. More rarely, such a complication as suppuration and infection occurs. In this happens, the inflammatory process begins in the body, the level of leukocytes and temperature rises.

After thyroid resection, replacement therapy is prescribed. Drugs and type of treatment are prescribed by a doctor. Often, treatment is carried out with radioactive iodine. At the end of the operation, the patient should be monitored by the attending physician, an endocrinologist or oncologist. In addition, it is important to regularly undergo a control ultrasound and to check the level of hormones.

The doctor prescribes synthetic or organic hormones to patients. This is necessary to compensate for the production of various substances that the thyroid gland previously produced. It is extremely important to listen to the recommendations of the doctor and not to ignore the medication. In case of any unpleasant or painful sensations, you should immediately consult a doctor. After subtotal resection of the thyroid gland, various disorders of all vital functions occur in the human body.

Watch the video: Thyroid lobectomy (February 2020).

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