METHOD OF SURGICAL APPROACH DETERMINATION IN SUSPECTED THYROID CANCER

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to oncology, endocrinology, surgery, and can be used in surgical approach determination in suspected thyroid cancer. Substance of the method consists in ultrasound-aided fine-needle aspiration biopsy. It is combined with multifocal fine-needle aspiration biopsy (MFAB) of thyroid (T) tissue. In the right and left lobes, biopsy of three segments is carried out, while in the isthmus - of one segment. Provided that histologic examination of a biopsy material shows diagnosed high differentiated thyroid cancer localised in one lobe and/or the isthmus only, video-assisted removal of the thyroid lobe and isthmus is required by a linear skin incision of the length up to 2.0-3.0 cm in the lower one-third of the neck at the thyroid level along a medial edge of the sternocleidomastoid muscle, dissection of skin, subcutaneous fat and platysma, release of a medial edge of the nodding muscle, separation of the sternohyoid and sternothyroid muscles with an endoscopic dissector to be thereafter drawn aside and slightly raised with a fibre endoscopic hook or a retractor with a channel for 4 mm telescope and a blood aspiration channel. After the thyroid lobe is uncovered, upward mechanical traction of tissues follows, and a video assisted endoscopic dissector is used to separate the superior thyroid artery to be clipped with a clipper with average large clips and transected with endoscopic scissors. The recurrent laryngeal nerve is separated and traced throughout with an endoscopic dissector video-assisted with a tenfold magnified displayed 4-mm telescope. Thereafter, the inferior thyroid artery is separated with an endoscopic dissector, clipped with a clipper with average large clips and transected with endoscopic scissors. Then the thyroid lobe and isthmus are removed.;EFFECT: use of the given invention allows to eliminates the possibility to miss malignant growths of thyroid tissues.;3 ex