Thyroid resection is a surgery in which part of the thyroid gland is removed. In this case, it is possible to cut out one or both lobes of the organ, but a small amount of tissue is left. Currently, 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 is aimed at removing the main part of the organ. There are cases when it is necessary to remove both lobes of the thyroid gland. During the procedure, the surgeon saves parts of tissues, the mass of which is less than 6 grams of the initial weight of the shares. Postoperative rehabilitation consists in undergoing 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. After all, with this disease, the only method of treatment is surgical intervention. The operation is also indicated for thyroid cancer, malignant tumors, in the presence of nodes and their increase by more than half a centimeter in six months.
Subtotal resection of the thyroid gland 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 be prescribed only if the patient does not have exacerbations of chronic diseases and his state of health is satisfactory. Approximately 3-6 months before the resection, the patient should receive thionamides.
Iodides are prescribed in about a week. This is necessary to reduce the volume of blood that enters the thyroid gland. You can prepare for the operation in another way. In this case, a short course of blockers in high doses is prescribed. In this case, thionamides are not prescribed. These blockers normalize the heart without affecting catabolism. This method is recommended for a mild degree of thyrotoxicosis in a patient and if he does not tolerate thionamides.
Performing an operation
Resection of the thyroid gland involves several stages. First of all, an ultrasound examination, which is performed by the operating surgeon, should be prescribed. With the help of this examination, it is possible to identify the location of the structure of the organ, the localization of the tumor, the state of the lymph nodes. Next, the doctor makes markings on the skin where the incision will be made.
After that, the anesthesiologist introduces the patient into a medical sleep, and the doctor proceeds to cut the skin along the markings. It should be noted 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 size of the incision is 2-12 centimeters. If the thyroid gland is removed completely, then the length of the dissection will be as large 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 muscles of the neck (short). Most often, the intersection is not applied, so the patient practically does not feel pain after the operation. This helps to reduce swelling and speed up the return of mobility.
Next, the doctor performs bandaging and crossing of the vessels. This is necessary in order to prevent injury to the external branch of the upper nerves of the larynx. After that, the recurrent nerve and parathyroid gland are released. It should be noted that the blood circulation of the thyroid gland is preserved. Next, a part of the gland is removed. The surgeon must bandage the blood vessels, and then remove the lobe of the thyroid gland.
If there are indications, 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 tissue. Most often, surgeons prefer central lymph node dissection. If metastases are detected in certain places, then lateral lymph node dissection is necessary. After that, the neck muscles are sutured and drainage is placed. It removes the remnants of blood. Next, cosmetic sutures are applied. Most often this is done using a material that is not absorbable. In this case, the suture is removed after the wound has healed. Absorbable material is also used. Then the removal of the seam is not required. In these cases, a specially designed adhesive can be used.
Postoperative period
Modern medicine involves operations on the thyroid gland, which take place without complications. The patient recovers quite quickly, and there is no need to stay in the hospital for too long. However, there is a possibility of complications. After subtotal resection of the thyroid gland, the patient may experience hoarseness. This can happen due to damage to the nerve of the larynx. 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 cannot always notice the injury of the larynx nerve during the operation in time. If the injury was bilateral, then paralysis of the vocal cords may occur. Such serious complications are very rare.
Postoperative bleeding is also possible 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. Even less common is a complication such as suppuration and infection. In this case, an inflammatory process begins in the body, the level of leukocytes and temperature rise.
After resection of the thyroid gland, replacement therapy is prescribed. Drugs and type of treatment are prescribed by a doctor. Often treated with radioactive iodine. At the end of the operation, the patient should be under the supervision of the attending endocrinologist or oncologist. In addition, it is important to have regular follow-up ultrasounds and check hormone levels.
The doctor prescribes synthetic or organic hormones to patients. This is necessary to compensate for the production of various substances that were previously produced by the thyroid gland. It is extremely important to listen to the doctor’s recommendations and not ignore the medication. If you experience any discomfort or pain, you should immediately consult a doctor. After subtotal resection of the thyroid gland, various violations of all vital functions occur in the human body.