Hemithireoectomy of the thyroid gland on the right and left: indications, preparation, course of operation, complications

According to statistics, 15% of the population have problems with the thyroid gland. Part of the disease is treated medically, but this technique is not always appropriate. All operations performed on the thyroid gland are complex.

They are appointed when conservative treatment has not given a positive result. One of the most common methods of treatment is hemithyroidectomy.

The concept of the

procedure This operation, involving the removal of one lobe of the gland with an isthmus. The choice of a part depends on the presence of a nodule formation. So, with a follicular form, the affected part is removed.

If the doctor prescribes the operation, it is best not to refuse it, because the complications can be very serious.

Indications for thyroid hemi-thyroidectomy

The most frequent reason for the operation is the nodes. In the prevailing number of patients, they are benign. But not in all cases the presence of education leads to surgical intervention.

Indications are:

• calcification node,
• formation with the presence of small clinical signs,
• formation of a large number of nodes,
• increase in education against a background of therapeutic treatment,

Preparation for operation

The preparation is to conduct:

• study of the level of hormones and antibodies,
• ultrasound of the glandand lymph nodes.
• examination of the vocal cords,
• MRI.

Scintigraphy and genetic examination are performed according to indications. The first method allows you to evaluate the activity of hormone secretion. For the study, radioactive isotopes are used. Genetic research reveals a medullary carcinoma.

A biopsy is performed before the operation. It allows to identify the qualitative composition of tissues and to make an assumption about the causes that led to the development of the disease. Special preparation from the patient is not required. The procedure takes about 40 minutes and under general anesthesia.

The course of the operation of hemithyroidectomy

Modern doctors make a small incision of the skin. On the one hand, its size should be sufficient to review the organs of the neck, and on the other - to provide the optimal cosmetic effect.

Procedure:

1. Marking is done on the neck, the patient is injected into the medicinal juice.
2. The physician provides access to the thyroid gland by making a cut in depth of 3 mm and a length of 6-8 cm.
3. The opening muscles of the neck are diluted bluntly.
4. The doctor visualizes the gland and assesses the exact location of pathological foci, the nature of damage to adjacent tissues.
5. After the revision, the surgeon allocates a recurrent laryngeal nerve and the most important structures.
6. The procedure for excision of the lobe and isthmus begins.

During the operation, hemostasis is performed. The fact is that the gland is surrounded by a large number of vessels. It is important to properly stop bleeding.

After the operation is completed, drainage is done and all affected parts are restored to the place. Dissected soft tissues are sutured with special threads, which after a few months dissolve themselves.

Complications of

If after the operation bleeding begins, then the manipulations are performed a second time to detect the source of bleeding.

Sometimes there are allergic reactions to anesthesia or other medications used. In this case, antihistamines are administered and resuscitation measures begin.

Among the complications there is a nerve damage with a violation of the voice function.

Then plastic of ligaments is spent, vitamins are appointed. Modern techniques allow minimizing problems, but the risk of their occurrence remains.

Note:

1. Larynx paresis. It is corrected by medical treatment, surgical way, special gymnastics.
2. Neck stiffness. Appointed exercise therapy, manual therapy.
3. Accession of infection. Antibacterial drugs are being treated.

Rehabilitation

After the manipulations the patient is transferred to the ward. The first day is recommended bed rest. If drainage is installed, then the next day it is removed. Patients note that after treatment there is a sore throat, muscle tension, soreness in the wound area.

During rehabilitation:

• avoid heavy physical activity,
• do not overwork,
• do not visit saunas and baths,
• replace sugar with honey and dried fruits.

In the presence of the cervico-shoulder syndrome, manual therapy is prescribed, and a psychotherapist is visited to correct the psychoemotional state. All physical complexes aimed at restoring the cervical department are used after consultation of the endocrinologist.