Skillful hands defuse mines! Xiangya Hospital successfully performs complex thyroid tumor surgery on a 76-year-old high-risk patient

Skillful hands defuse mines! Xiangya Hospital successfully performs complex thyroid tumor surgery on a 76-year-old high-risk patient

Recently, Professor Li Xinying's team from the Department of Thyroid Surgery at Xiangya Hospital of Central South University successfully performed a complex thyroid tumor surgery on Mr. Zhang, a 76-year-old man who suffered from multiple underlying diseases .

The operation consisted of "complete bilateral thyroidectomy + parathyroidoma resection + bilateral central neck and right II-V zone neck lymph node dissection + mediastinal lymph node resection". The patient recovered well after the operation and has been discharged smoothly.

Mr. Zhang discovered a thyroid nodule two months ago. After seeking medical treatment in many hospitals without success, he came to Xiangya Hospital. After admission and relevant examinations, it was found that Mr. Zhang's right thyroid nodule was medullary thyroid carcinoma, with the primary lesion larger than 6 cm and a fixed mass. There was right lateral cervical lymph node metastasis, with the largest metastatic lymph node exceeding 5 cm, fused with each other, invading the internal jugular vein, sternocleidomastoid muscle and closely related to the subclavian vein. At the same time, multiple lymph node metastases in the upper mediastinum were combined.

Considering Mr. Zhang's advanced age and his underlying diseases such as hypertension, diabetes, and severe pulmonary ventilation dysfunction, the tumor may have invaded the trachea, esophagus, recurrent laryngeal nerve, and right subclavian vein, and the mediastinal lymph nodes may require thoracotomy, which is a high-risk operation. Therefore, Professor Li Xinying's team invited experts from the Department of Cardiovascular Surgery, Department of Respiratory Medicine, and Department of Anesthesiology to conduct a multidisciplinary consultation .

Experts conducted a comprehensive assessment of the patient and suggested that special attention should be paid to airway management, improvement of lung function and perioperative respiratory risks before surgery. During surgery, multiple departments may need to perform surgery together. Under the guidance of the respiratory department, Mr. Zhang received combined nebulizer therapy before surgery to improve lung function and reduce the risk of intraoperative dyspnea and postoperative pneumonia.

On January 16, the operation went smoothly. Professor Li Xinying's team first completed the complete removal of the patient's bilateral thyroid glands. The intraoperative pathology report showed that the right thyroid gland was medullary carcinoma, and the central lymph nodes also showed cancer metastasis, which was consistent with the metastatic characteristics of malignant tumors. At the same time, because the patient's right superior parathyroid gland met the characteristics of parathyroid adenoma, the team also removed it. In order to completely remove the tumor and reduce the possibility of recurrence, Professor Li Xinying decided to perform lymph node dissection in the bilateral central neck area and right II-V zones, and at the same time expanded the removal of the invading sternocleidomastoid muscle and internal jugular vein.

After completing the above operations, Professor Li Xinying completely removed the patient's superior mediastinal lymph nodes through fine neck dissection, avoiding thoracotomy and greatly reducing the patient's trauma. With the cooperation of the anesthesiologist, the patient's airway management was effectively guaranteed during the operation, and the operation was successfully completed.

In order to promote the early recovery of Mr. Zhang's lung function after surgery, head nurse Hu Yuanping instructed the patient to perform lung rehabilitation breathing exercises. Under the careful care of the team, Mr. Zhang did not have any complications, recovered smoothly, and was discharged from the hospital on January 20. On January 24, the ward telephone follow-up learned that the patient recovered well and had no special discomfort.

Professor Li Xinying, director of the Department of Thyroid Surgery at Xiangya Hospital of Central South University , said that the successful completion of this operation provided valuable experience for the future treatment of similar locally advanced thyroid cancer with large vessel invasion and mediastinal lymph node metastasis.

Hunan Medical Chat Special Author: Luo Yan, Hu Yuanping, Xia Xiuzhi, Xia Fadada, Xiangya Hospital of Central South University

Follow @湖南医聊 to get more health science information!

(Edited by YT)

<<:  Good health is coming丨Take a hot spring bath during the Spring Festival holiday, “three do’s” + “three don’ts”, take a look!

>>:  The Spring Festival is approaching. How can patients with cardiovascular and cerebrovascular diseases celebrate the New Year in a healthy way? Get this "treasure guide" now

Recommend

Bleeding at 40 days of pregnancy

Pregnancy is a process that most women will go th...

Why do women have stomach pain in the morning?

Most women have abdominal pain. Experts suggest t...

Which is better for surgical breast correction?

The place where the outer edge of the breast meet...

What is the reason for brown discharge when wiping after peeing?

As we all know, due to physical reasons, women...

What is the best way to prevent pregnancy after removing the IUD?

After the IUD is inserted, if you do not want to ...

Taboos for girls with low blood pressure

Hypotension is a common disease among many people...

First day of menstruation

There are often many problems with menstruation, ...

What time at night should I run to lose weight?

Maintaining a good figure is everyone's wish....

How long does it take to get pregnant after hysterosalpingography?

The fallopian tubes are particularly important fo...

Is it normal to have your period four days early?

Menstruation is a physiological phenomenon that e...

How long after a caesarean section can I have a second child

With the opening of the national two-child policy...

Is it normal for the placenta to be on the right side of the uterus?

For women, the most worrying thing during pregnan...

Picture of the cervix opening during childbirth

The cervical opening is medically known as the di...