METHOD OF SURGICAL TREATMENT OF THYROID CANCER WITH METASTASES TO THE LYMPH NODES OF THE CENTRAL TISSUE OF THE NECK Russian patent published in 2023 - IPC A61B17/00 

FIELD: medicine; surgery; oncology.

SUBSTANCE: surgical access is provided. Sequentially, first from one side, and then from the contralateral side, the sternothyroid muscle is dissected in the area of attachment to the thyroid cartilage, the muscle branches of the anterior branch of the superior thyroid artery are ligated. Then the upper pole of the thyroid lobe is separated from the lower constrictor of the pharynx, and in this space below the line of attachment of the sternothyroid muscle to the thyroid cartilage, the external branch of the superior laryngeal nerve is identified. After that, the anterior branch of the superior thyroid artery is selectively ligated. The visceral sheet of the internal fascia of the neck is opened at the superior aspect of Berry's ligament with precision preservation of the posterior branches of the superior thyroid artery and its anastomoses with the branches of the inferior thyroid artery. At the same time, this zone is inspected posteriorly to the esophagus to detect the upper parathyroid glands. After ligation of the inferior branch of the inferior thyroid artery, the isthmus of the thyroid gland is crossed. Further, alternately from the lateral, and then from the medial side, approaching the tubercle of Zuckerkandl, the vascular pedicle of the thyroid gland is formed with precise isolation and preservation of the anterior extralaryngeal branch of the recurrent laryngeal nerve. Extirpation of the lobe of the thyroid gland is performed. After that, a revision of the central tissue of the neck to the thymus is carried out with visualization of the mediastinal branches of the inferior thyroid artery or branches of the unpaired thyroid artery. If parathyroid glands are detected, ipsilateral central lymph node dissection is performed with preservation of the parathyroid glands and their vessels. Then the entire sequence of actions is carried out from the contralateral side.

EFFECT: method improves the results of surgical treatment of thyroid cancer with metastases in the central tissue of the neck, reduces the risk of postoperative complications, improves the quality of life of patients, and prevents severe chronic diseases in the late postoperative period.

1 cl, 7 dwg, 1 ex