Surgical treatment of hyperthyroidism is held with severe thyrotoxicosis, with no effect on the purpose of antitiroidnyh drugs tirostatikov, with a large increase in thyroid cancer. Quite often, this treatment is best for children and pregnant women.
When surgical treatment is performed surgery to remove most of the thyroid gland. The operation is called a subtotal resection of the thyroid gland subfascial. At the same time removes the main part of the thyroid gland. Leave small areas of cancer in the posterolateral parts of shares of the thyroid. Typically, the mass of these pieces of prostate from three to five grams.
Before operative treatment obligatory in preparation of the patient. Necessary to minimize the manifestations of thyrotoxicosis. Appointed by the iodine for at least two weeks. While receiving these drugs reduced manifestations of thyrotoxicosis, and a simultaneous decrease in blood flow increased thyroid gland. Decreased blood supply to the thyroid gland is achieved by prevention of massive bleeding during surgery gland. Always assigned to beta-blockers not only before but after the operation.
If necessary, an emergency operation shall be appointed glucocorticoid hormones in high doses (betamethasone), beta-blockers, iodine preparations. Appointed tirostaticheskie drugs, both before and after surgery to prevent tirotoksicheskogo crisis.
Complications after surgery to remove the thyroid gland can be divided into early and late.
By the early complications include the possibility of bleeding from the wound. At the same time the blood can get into the larynx and prevesti to asphyxia (suffocation). Sometimes during surgery may be inadvertently damaged by recurrent nerve, which innervates the vocal cords. In this case, lead to abnormalities in the complete disappearance of voice vote.
By the late complications of hypothyroidism include tiroidektomii and hypoparathyroidism.
Hypothyroidism occurs when the insufficiency of the remaining sections of the thyroid gland.
Hypoparathyroidism may occur when removing the thyroid gland removed as well and parathyroid glands. Sometimes after surgery the patient relapse of diffuse toxic goiter. It is believed that the risk of recurrence of up to 20%, depending on the qualifications of the surgeon.