Patients requiring thyroid surgery should not be afraid of complications of such surgery. New methods allow it to be carried out safely, say the specialists who met on Friday at the conference in Krakow.
Fear of surgery is one of the main reasons for postponing it, and sometimes for an indefinite future, said Prof. Wojciech Nowak, head of the 10rd Department of General Surgery at Collegium Medicum of the Jagiellonian University in Krakow. Meanwhile, XNUMX percent. patients with thyroid diseases should be treated by surgical methods. Some of the patients, most at risk of complications, can be operated on using the so-called neuromonitoring, a device that allows you to precisely determine the place where the retrograde laryngeal nerve runs.
On Friday, the XNUMXst conference on the neuromonitoring of the laryngeal nerves of the thyroid surgery began in Krakow.
Dr hab. Marcin Barczyński from the XNUMXrd Department of General Surgery in Krakow told PAP that the device minimizes the risk of damaging this nerve, which is one of the more serious complications in thyroid surgery. Violation of the laryngeal nerve causes hoarseness or silence. In some patients it is only temporary. But it happens that the voice damage is permanent and requires the use of the so-called tracheotomy tube to ensure proper breathing. And this is what the sick fear the most.
Until now, surgeons could find out about the damage to the laryngeal nerve only after the operation – after the first conversation with the patient. During the procedure, neuromonitoring allows you to check how it proceeds and where is the safe field of the operation – said Dr. Barczyński. This is especially important in patients who already have damaged one of the laryngeal nerves.
In Germany, over 90 percent. thyroid surgery is performed this way. The use of monitoring is required there in every center that carries out such procedures. In Poland, neuromonitoring in thyroid surgery is used only in 3%. thyroid surgery. Outside Krakow, where the most of them are performed (over 200 per year), there are, among others, in Łódź, Gdańsk and Białystok. The National Health Fund does not reimburse this treatment method yet.
In Poland, we perform 20 thousand. thyroid surgery. We want neuromonitoring to be used at least in those procedures where the risk of damage to the laryngeal nerves and voice impairment is the highest – in operations for thyroid cancer or recurrent goiter – said Prof. Wojciech Nowak. Delaying, including refusing to undergo the procedure, makes treatment difficult or even impossible, because the best results are achieved when the therapy is started at an early stage of the disease.
In the case of goiter, surgery is necessary when the thyroid gland grows beyond the sternum or in the mediastinum, as well as when it constricts the airways and makes it difficult to breathe properly. The first cause for concern is that you feel a hard lump in the neck or the circumference of the neck is growing rapidly. Symptoms of an enlarged thyroid gland can be irritability, weight loss, irregular heartbeat, and even shortness of breath with little physical exertion.
The most common cancers of the thyroid gland are follicular and papillary cancer. They grow slowly but have a tendency to relapse; they have better prognosis in patients under 45 years of age. Medullary carcinoma has a good prognosis when confined to the thyroid gland. The most dangerous is anaplastic cancer, which grows rapidly and responds poorly to treatment.
Zbigniew Wojtasiński (PAP)