FIELD: medicine, surgery.
SUBSTANCE: about 2-3 h before operation one should lymphotropically inject antibacterial preparation into pre-tracheal fiber. One should form an access to thyroid gland due to cervical incision without separating cutaneous-fatty fragments so, that wound angles should be the level of median edges of sterno-clavicular-mastoid muscles. One should divide at different levels: right and left sterno-hyoid muscles - being nearer at the upper edge of the wound, and right and left sterno-thyroid - at the lower edge. One should thoroughly isolate, tighten and cross the upper, at first, and then the lower thyroid veins, arteries and lymph vessels by keeping branches that feed parathyroid glands before the onset of thyroid manipulations. One should loose at first the upper and then the lower thyroid pole at mobilization of which one should visualize and isolate, if necessary, the lower parathyroid glands. One should isolate partially reflexive laryngeal nerve at the length of 1-1.5 cm, in area of its juncture with posterior-lateral thyroid surface and transition to a larynx. Moreover, one should visualize and, if necessary, isolate the upper parathyroid glands. After removing pathologically altered thyroid tissue one should perform the connection of crossed sterno-thyroid and sterno-hyoid muscles with longitudinal sutures. In cross-sectional direction by forming a trachea-covering muscular-fascial carcass. The method enables to avoid relapse of pathological process and, also, prevent the onset of specific complications such as laryngeal paresis and paralysis, transitory or constant hypoparathyreasis, intra- and postoperational hemorrhages.
EFFECT: higher efficiency of therapy.
2 cl, 1 ex
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Authors
Dates
2005-08-10—Published
2004-02-10—Filed