Edema of tissues after thyroid surgery
Despite the high level of medicine,qualification of doctors and modern equipment, surgery on the thyroid gland always causes anxiety in patients. And these fears are not always vain, because after the operation on the thyroid gland sometimes there are complications of a different nature.
Statistics show that approximately 10% of patients in the postoperative period suffer from some complications. And even if the operation was very successful, it can be stated unambiguously that the patient will have to take hormonal preparations in the postoperative period and for the rest of his life.
Thyroid gland in our body performsthe role of the storage of iodine and the synthesizer of hormones T3 and T4. These hormones play a very important role in many metabolic processes of our body - regulate the activity of the cardiovascular system, the gastrointestinal tract, the genitourinary system, and many others. Therefore, the correct activity of the thyroid gland is so important for us - any deviations from the norm inevitably affect the performance of other organs of our body.
Thyroid pathologies are seriousa problem of the present, and on prevalence take the second place after a diabetes. About one in ten women and one in twenty men faced with one or another of thyroid problems, and about 1.5 billion people on the planet suffer from a total of thyroid gland diseases.
Thyroid activity is regulatedthe brain, or rather, the part that is called the pituitary, so a number of abnormalities in the functioning of the gland can be associated with pituitary diseases - craniocerebral trauma, tumors, hereditary or genetic disorders. Some thyroid pathologies can be treated with conservative methods, and some require mandatory surgical intervention.
All diseases of the thyroid gland can be divided into 3 large conditional groups.
- The first group includes diseases associated withwith excessive thyroid synthesis of thyroid hormones T3 and T4. Such an anomaly can be caused by various reasons, for example, the formation of goiter, which, without submitting to the commands of the pituitary, begins to systematically in large quantities secrete hormones, thereby significantly raising the hormonal background and causing a number of serious disorders in the functioning of other organs of our body.
- The second group includes diseases associated withwith a reduced level of secretion of thyroid hormones T3 and T4. This disorder is often associated with autoimmune diseases. The essence of autoimmune pathologies is that our autoimmune system, designed to protect the body from various pathogenic microorganisms and cells, begins to fail. That is, it begins to perceive the cells of the thyroid tissue for "enemy" and, developing antibodies, begins to suppress them in every possible way, and even destroy them. As a result of such an error, the gland tissue decreases, and, accordingly, the secretion of thyroid hormones so necessary for our body decreases. The consequences of surgery on the thyroid, in view of the loss of part of the tissue just cause such a low state of the hormonal background. And this condition will be determined by the fact that resection of a part of the tissue will inevitably cause weakening of the hormonal background, which will force the patient to take hormonal preparations for the rest of his life.
- And, finally, to the third group of violations related towith thyroid gland are diseases that are not related to hormonal activity of the thyroid gland. These pathologies are related to an increase in the size of the thyroid gland, the formation of nodes, goiter and tumors. In this case, tumors and nodes are not necessarily cancerous, they can be completely benign, but they give the patient a serious discomfort: they change the shape of the neck, interfere with the respiratory-swallowing process, voice disturbances can occur.
For each of these disease groupsprovide their own methods of diagnosis and treatment, but the general sequence of laboratory research and decision-making on the method of treatment has much in common.
In the diagnosis of thyroid diseasegland over the past 2 decades, there was a significant breakthrough. Already far behind there are times when the diagnosis was made only on the basis of palpation, although to this day palpation of the thyroid is always mandatory for initial examination, allowing you to quickly assess the size of the thyroid gland, the presence of nodes and tissue density.
After palpation, the patient is usually referred toultrasound examination of the neck area, where with the help of an ultrasound scanner it is possible to reveal the exact outline of the gland, and to draw a conclusion about the uniformity of the tissue. Ultrasound can make a conclusion about the presence of neoplasms and changes in the uniformity of the gland tissue - diffuse changes.
A real revolution in the diagnosis of diseasesshchitovidki has made a method of a thin needle-like biopsy, which was invented back in the 90s of the last century, but was widely used only in our days. The biopsy proved to be an effective diagnostic method, which reduced the number of surgical operations on the thyroid gland by 20 times!
The essence of the method is that for adoptiondecisions about the need to remove the entire thyroid gland, its part or neoplasm, it is necessary to know the structure of the tissue. That is, whether it is possible to treat the disease or should be immediately removed, a malignant tumor or benign. For this, a thin needle is inserted into the problem site of the gland and a small tissue puncture is sampled for subsequent laboratory analysis.
And, finally, the most modern and progressivemethod of diagnosis - scintigraphy. The mechanism of scintigraphy is the ability of the gland to absorb iodine. The patient swallows a solution with an isotope of radioactive iodine, and after 24 hours the thyroid gland is removed in a gamma camera. As a result of the light radiation emitted by the iodine isotope, which was "absorbed" by the thyroid gland, specialists receive a three-dimensional image of the gland with clearly pronounced "warm" and "cold" zones.
Warm zones characterize areas with increasedsecretion of thyroid hormones, and cold - with a decreased secretion. By results of these researches it is possible to diagnose precisely disease and those sites which are amazed, and accordingly to choose the necessary method of treatment.
Based on the diagnosis, a decision is made onchoice of a method of treatment - conservative or operative. If, as a result of the diagnosis, the malignancy of the tumor has not been established or the size of the goiter does not exceed the dimensions causing discomfort for breathing and swallowing, a decision is made on the use of drug therapy or irradiation with radioactive iodine. Otherwise, resection of thyroid tissue is prescribed.
Resection of thyroid gland is of 4 main types:
- removal of one of the thyroid glands;
- removal of the entire tissue of the thyroid gland;
- removal of part of the tissue of the entire thyroid gland;
- operation of lymph nodes.
Each type of resection can have both general and specific complications in the postoperative period.
All complications in the postoperative period can bedivided into 2 groups. The first group includes complications that are inherent in any surgical operation, and the second group includes specific complications inherent in surgical interventions in the area of thyroid removal.
Postoperative follow-up at the station
General complications are quite rare, the patient's condition is satisfactory and they occupy no more than 3% of cases, they are amenable to treatment:
- bleeding after surgery;
- suppuration of a postoperative wound;
- postoperative edema of the neck.
If the operation was successful and the patient's conditionno worries, long-term rehabilitation, diet and recovery. If the operation has not gone quite smoothly, then the specific consequences of removing the thyroid tissue can be as follows:
- damage to one or both return nerves;
- the seam;
- full or partial loss of voice;
- hypothyroidism - a decrease in thyroid function due to the secretion of hormones.
The most common and unpleasant inpostoperative complication is damage to the recurrent nerve. The loss of voice can be restored in 80% of cases, but there is a danger of complete irreversible loss of voice. In this case, one more operation will be required to restore the disturbed recurrent nerve and attempt to restore the voice.
Suture at the site of surgery to remove the proportion of thyroid glandcan affect the voice tone change. The consequences of joint formation do not always require urgent intervention and treatment, since after a short time the seam can dissolve independently due to cellular metabolism at the site of the operation.
Postoperative condition of the patient will beto determine such consequences as hypothyroidism and hormonal imbalance that every patient will have to face after the operation on the thyroid gland and these consequences will have to be taken into account throughout the subsequent life. This is due to the fact that as part of the tissue or the entire tissue of the thyroid gland is removed, the gland can no longer secrete the desired amount of hormones.
Therefore, postoperative rehabilitation and allthe further life will be connected with preparations of hormonal replacement. Also for the rest of his life, it will be necessary to adhere to a not very strict, but still limited diet.