內容目錄
On February 5, Zaozhuang Cancer Hospital (Zaozhuang Chest Hospital) admitted an 89-year-old man who had been suffering from paroxysmal cough and dyspnea for more than 2 months due to the discovery of a neck mass for more than 5 years.
(thyroid CT examination after admission)
After admission, the patient was asked for medical history 4 years ago He was admitted to the provincial hospital due to a neck tumor and was diagnosed with a retrosternal thyroid. The proposed treatment plan was to remove the retrosternal thyroid through the chest. The operation required thoracotomy and sternum splitting. Considering that the patient was 85 years old at the time, the risk of surgery was too great, and conservative treatment was recommended. Later, the patient went to many hospitals for conservative treatment, and even took Chinese herbal medicine to control the further enlargement of the thyroid gland. .
After being admitted to the third department of surgery, Chief Physician Kong Bin and his team had a heated discussion on the patient’s treatment plan, and finally agreed that: the patient’s advanced age and the difficulty of the operation exist objectively. The thyroid gland compresses the large airway, and the patient’s asthma symptoms gradually increase. If it continues to develop, it will lead to the collapse of the trachea, suffocation, and eventually the patient’s death. Surgical removal of the huge thyroid gland is the only effective way to relieve the symptoms. To this end, the team developed a detailed perioperative treatment plan to actively improve cardiopulmonary function before surgery.
The thyroidectomy is performed by free method through the neck incision to avoid side injuries such as thoracotomy and sternum split to ensure the safety of the operation; , and transferred to the intensive care unit for further treatment if necessary.
After fully perfecting the preoperative preparations, the operation started in an orderly manner on February 16, with anesthesia, disinfection, skin incision, dissociation, ligation, and protection of the recurrent laryngeal nerve, vital organs and blood vessels. After 2 hours of careful operation and team cooperation, the enlarged thyroid was finally completely removed and the pressure factor on the large airway was relieved. Intraoperative and postoperative patient monitoring equipment showed that everything was normal.
48 hours after the operation, the patient was able to get out of bed voluntarily, and his food intake was normal. The patient said that, unlike before the operation, his breathing was smoother, and the “hands” holding his neck disappeared. The patient’s family members sent pennants to the third department of surgery with excitement.
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