Hemithyroidectomy is an surgical intervention that is aimed at removing one lobe of the thyroid gland.
This type of operation is advisable to carry out at the early stages of development of benign and malignant processes, but only if they are localized within the boundaries of one share.
During the operation, not only the lobe is removed, but also the isthmus - the part that connects the affected lobe to a healthy one. Modern medical professionals use endoscopic hemithyroidectomy. This is the most gentle minimally invasive technique, which provides for minor injuries and quick recovery.
Indications for hemithyroidectomy are neoplasms, primary malignant tumors, calcification of the thyroid gland nodes, the formation of several nodes, chronic thyroiditis, as well as large nodular tumors.
Preparation for surgery
Before the operation, it is important to prepare for it in advance. First of all, you need to go through studies of the level of hormones and antibodies, ultrasound of the thyroid gland and lymph nodes.
Also, the doctor should examine the vocal cords of the patient and give direction to magnetic resonance imaging.
According to certain indications, the doctor may prescribe scintigraphy and genetic testing. Scintigraphy allows you to evaluate the activity of hormone secretion. In this case, radioactive isotopes are used. Genetic research allows you to determine medullary carcinoma.
A biopsy is also prescribed before surgery. With its help, you can determine the qualitative composition of the tissue and suggest the reasons that contributed to the development of the disease. No preparation is required for this. The procedure is approximately 40 minutes and takes place under general anesthesia.
Doctors are currently making a completely small skin incision. Of course, first of all, the size of the incision should provide a complete overview of the organs of the neck, but doctors also care about the maximum cosmetic effect.
Surgery is performed without crossing the short muscles of the neck, which reduces swelling and pain after surgery. A harmonious scalpel is used for all manipulations. With this tool, blood loss can be significantly reduced.
The surgeon makes a marking on the neck, and the anesthetist introduces the patient into a medical sleep. The depth of the cut is approximately 3 mm, and the length is 7-8 cm.
The opened muscles are bred in a blunt way. The doctor visualizes the organ and evaluates the exact location of the pathological foci and the nature of the lesions.
Next, the surgeon allocates the recurrent nerve of the larynx and all the main structures of the organ. After this, the proportion and the isthmus is excised. During hemithyroidectomy, hemostasis is performed, since there are many vessels around the gland.
Therefore, it is very important that the doctor conducts the correct stop of bleeding. After the operation is completed, drainage is performed and all damaged soft tissues are sutured with special medical threads that resolve on their own after a few months.
Complications and rehabilitation
If the patient bleeds after the operation, the doctor re-manipulates in order to detect the source of bleeding. Also, a person may experience an allergic reaction to anesthesia or other drugs used. In this case, antihistamines are administered and resuscitation is performed. Therefore, it is important to talk with an anesthetist before surgery, talk about a possible allergy, and do all the necessary research.
One of the complications is nerve damage and impaired vocal function. In this case, plastic of the vocal cords is performed and vitamins are prescribed.
It is worth noting that modern medicine can minimize problems, but there is still a risk of their occurrence. Paresis of the larynx is corrected with medications, a surgical method and special gymnastics. With neck stiffness, physical therapy and manual therapy are prescribed. In infections, antibiotic therapy is performed.
After all the manipulations, the patient is transferred to the ward. In the first 24 hours, bed rest is recommended.
If drainage is installed, then remove it the next day. Patients note that after surgery, there is a sore throat, muscle tension and soreness in the wound area. Therefore, during the rehabilitation period you should avoid heavy physical exertion, refuse to visit saunas and baths, replace sugar with honey and try not to overwork.
The healing process will be faster if you follow all the doctor's recommendations and take the prescribed medications.
If, after hemithyroidectomy, a problem such as cervicobrachial syndrome occurs, then the patient is prescribed manual therapy. To restore the psychoemotional state, a psychotherapist should be visited. Any physical exercises aimed at restoring the cervical spine are used exclusively after consulting an endocrinologist.