Thyroid surgery indications, necessary steps for surgery

In clinical practice, surgical treatment is a relatively common method for the treatment of thyroid diseases. Therefore, this article will introduce the indications and steps of thyroid surgery.

Adaptation

Thyroidectomy can be divided into total resection and subtotal resection. Total resection is suitable for thyroid cancer and malignant lymphoma. Subtotal resection is suitable for 1. Simple thyroid gland that compresses the trachea and esophagus; 2. Nodular thyroid gland with hyperthyroidism or suspected malignant changes; 3. More severe hyperthyroidism that has not been effectively treated with drugs for about a year.

1. Multiple thyroid adenomas limited to one lobe.

2. A giant adenoma or cyst that occupies one lobe, obliterating the normal thyroid tissue structure.

3. A small solitary nodule, which was confirmed to be carcinoma in situ by pathological examination.

Surgical procedures

1. The body position, incision, and exposure are the same as those for subtotal thyroidectomy.

2. Expose the thyroid gland After exposing the thyroid gland, separate and cut the thyroid ligament, deal with the upper pole blood vessels of the thyroid gland, and then ligate and cut the middle and lower thyroid veins. Deal with the inferior thyroid artery, ligate and cut it, close to the inner side of the carotid artery, or use the intracapsular ligation method to deal with the inferior thyroid artery.

3. Cut off the thyroid septum. Use curved hemostatic forceps to bluntly separate the thyroid septum in front of the trachea and cut it off.

4. Remove the lateral lobe of the thyroid gland, either from the upper pole downward or from the lower pole upward, or start from the sulcus to separate the back of the thyroid gland. At this time, the recurrent laryngeal nerve and parathyroid gland should be carefully identified and protected to avoid damage.

5. Stop bleeding and suture After the bleeding is completely stopped, place a drain, suture layer by layer, and close the incision.