Red Net Moment News, July 14th (Correspondent Lei Chunsha) Recently, 66-year-old Mr. Li came to Changsha No. 1 Hospital for treatment due to neck discomfort and poor breathing. You wouldn’t know without checking, but when you checked, you were shocked to find that Mr. Li had bilateral thyroid enlargement, especially the enlarged thyroid nodule on the right side, which had even grown to the back of the sternum, compressing the trachea, seriously affecting Mr. Li’s breathing and Life.
Mr. Li is eager to eradicate the disease, but he has infectious diseases and has huge thyroid nodules, which faces the risk of surgery.
Director of Breast and Thyroid Surgery Department Jiang Yaling and Director of Infection Surgery Department Yang Ke discussed countermeasures, formulated a thorough and detailed treatment plan for the patient, and conducted multidisciplinary MDT discussions to formulate individualized surgical plans and various emergency plans for the patient.
htmlOn July 4, a multidisciplinary team performed a total right and isthmus thyroid lobectomy + left subtotal thyroidectomy for Mr. Li under general anesthesia . The operation went smoothly, and the diseased thyroid tissue removed during the operation was five times the size of the normal thyroid gland.
Jiang Yaling said that retrosternal goiter surgery is more difficult than ordinary thyroid surgery. The whole process requires the use of delicate lifting methods to remove the huge thyroid tumor bit by bit. Although doctors have to face several times more difficulty and effort than ordinary surgery, there is no doubt that this approach can avoid the risk of thoracotomy and related postoperative complications for patients.
Popular science knowledge:
Retrosternal goiter refers to goiter in the mediastinal area behind the sternum, and the incidence rate accounts for 1% to 15% of goiters. Substernal goiter is the same disease that affects the thyroid gland in the neck, and can be goiter, thyroid adenoma, hyperthyroidism, inflammatory diseases, thyroid cancer, etc.
Symptoms are mostly related to the enlarged goiter compressing the chest organs. The severity of symptoms is related to the size, location and growth rate of the tumor, and whether it compresses adjacent organs.
Compression of the trachea can cause dry cough, chest tightness, and difficulty breathing.
Compression of the esophagus can cause dysphagia .
Compression of the superior vena cava can cause superior vena cava syndrome , which manifests as venous congestion in the head and neck and superficial varicose veins in the anterior chest wall.
Compression of the recurrent laryngeal nerve will cause vocal cord paralysis and hoarseness.
Once a retrosternal goiter is diagnosed, it should be surgically removed as soon as possible, even if the patient has no obvious symptoms. The surgical approach to substernal goiter depends on the specific circumstances. Selection principle: First, make a low collar incision on the neck. If there is malignant transformation or severe adhesions, a median sternotomy will be added. Some retrosternal goiters require thoracotomy..
Precautions
① The thyroid gland is an important endocrine gland in the human body. After surgery, the thyroid gland needs to be reviewed regularly and thyroxine supplemented if necessary.
② Postoperative diet and taboos need to be adjusted according to thyroid function.
③ The transverse neck incision after surgery generally heals well, is located low and is blocked by neck lines , so female patients do not need to be anxious.
