Thyroid Adenoma Resection

1. Isolated thyroid nodules, including thyroid adenomas and thyroid cysts. 2. The cancer rate of thyroid adenoma is about 10% to 20% higher, and the adenoma should be sent for pathological examination after resection. In particular, there are obvious adhesions during the operation. Suspected cancerous patients should be sent to the frozen section immediately after removal. If it is malignant, it should be changed to radical treatment. 3. When thyroid adenoma combined with hyperthyroidism, subtotal thyroidectomy should be performed, and simple adenoma should not be removed. Treatment of diseases: thyroid adenoma simple goiter Indication 1. Isolated thyroid nodules, including thyroid adenomas and thyroid cysts. 2. The cancer rate of thyroid adenoma is about 10% to 20% higher, and the adenoma should be sent for pathological examination after resection. In particular, there are obvious adhesions during the operation. Suspected cancerous patients should be sent to the frozen section immediately after removal. If it is malignant, it should be changed to radical treatment. 3. When thyroid adenoma combined with hyperthyroidism, subtotal thyroidectomy should be performed, and simple adenoma should not be removed. Contraindications 1. Patients with young age and mild condition. 2. Older age, combined with severe heart, liver, kidney and other diseases and difficult to tolerate surgery. Preoperative preparation 1. Treatment of oral infections (such as dental caries, tonsillitis); cysts ruptured into sputum and snoring, should be anti-infection, surgery after the inflammation subsided. 2. Use 3% boric acid water to contain strontium 3 days before surgery. 3. The lower part and neck skin are prepared regularly. Surgical procedure 1. Position, incision: position and subtotal thyroidectomy. On the sternal notch, 2 horizontal fingers are cut along the dermatoglyph. The incision should be close to the adenoma, and the length depends on the size of the adenoma. 2. Exposure of adenoma: separation of the flap and severance and separation of the anterior thyroid muscle are all subtotal thyroidectomy. After the thyroid is revealed, a thorough examination is performed to determine the location, number and nature of the lesion. If the adenoma is small, the anterior thyroid muscle group can be fully pulled to the left and right sides, and the muscle group is not necessarily cut off. 3. Resection of adenoma: If the cyst is multi-line, you can suture or clamp the blood vessels of the thyroid tissue on the surface of the adenoma, then cut the surface of the thyroid tissue, directly to the surface of the adenoma, with curved vascular clamp or finger along the adenoma The surrounding area was bluntly separated until the pedicle, and the adenoma was peeled off from the surrounding thyroid tissue, and the pedicle was clamped, cut, and ligated to remove the adenoma. When there is a bleeding point in the stripping process, the blood should be clamped to stop bleeding. After the adenoma is removed, the vascular tissue clamped by the vascular clamp must be ligated one by one. Finally, the thyroid tissue and the thyroid capsule were sutured intermittently with a thin wire to eliminate the residual cavity left after the adenoma was removed. If it is a solid adenoma, the 1 cm normal gland tissue around the tumor should be removed together during the resection. 4. Drainage and suture: After careful hemostasis, a rubber sheet is placed in the adenoma, and the incision is taken out from the side of the incision, and then the incision is sutured layer by layer. complication 1. Postoperative dyspnea and asphyxia: This is the most critical complication after surgery, which occurs within 48 hours after surgery. Common causes are: 1 intra-incision hemorrhage, hematoma formation, compression of the trachea; 2 tracheal collapse; 3 laryngeal edema; 4 bilateral recurrent laryngeal nerve injury. Clinical manifestations include progressive dyspnea, irritability, cyanosis, and even suffocation. If it is caused by bleeding in the incision, there may be swelling of the neck and bleeding of the incision. When the above situation is found, the patient should be immediately rescued by the patient's bed, the suture should be cut open, and the incision should be opened to remove the hematoma. If the hematoma is removed, the breathing difficulties will not improve, and the tracheotomy should be performed immediately. Tracheal collapse is often softened by the pressure of the giant thyroid gland. When the gland is removed, the trachea loses support and collapses. Therefore, tracheotomy should be performed during the operation. Once the laryngeal edema appears, the head should be taken at a high position to fully supply oxygen. If it is not good, the tracheotomy should be performed in time. Bilateral recurrent laryngeal nerve injury can cause bilateral vocal cord paralysis and cause severe breathing difficulties, requiring tracheotomy. 2. Thyroid crisis: The cause has not been affirmed, the occurrence of crisis is mostly due to insufficient preparation before surgery, and the symptoms of hyperthyroidism are not well controlled. Thyroid crisis occurs in 12 to 36 hours after surgery, which is characterized by high fever, fast and weak pulse (more than 120 times per minute), irritability, paralysis, and even coma, often accompanied by vomiting and watery diarrhea. If the treatment is not timely or improper, the patient often dies very quickly.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.