SURGICAL TECHNIONE OF TOTAL THYROIDEOTOMY

SURGICAL TECHNIONE OF TOTAL THYROIDEOTOMY
Total thyroidectomy with or without dissection of neck lymph nodes provides the best results in treatment of the majority of patients with papillary thyroid carcinoma (PTC). Total thyroidectomy (TT) removes intrathyroid metastases or multicentric tumors, provides decrease of local relapses and distant metastases as well as the risk of anaplastic transformation of a residual cancer. After the TT the discovery of eventual local relapses and distant metastases is easier because thyrglobulin can be used as a marker of recurrence and I131 is useful in the diagnosis and treatement. Therapeutic disection of regional lymph nodes of the neck decrease the frequency of relapses and provides the precise definition of the disease stage. The fundament for succses of these operations is prevention of complications, in the first place injury of laringeal reccurent nerve and hypoparathyroidism. This video-tape presents the technique of the total thyroidectomy with dissection of central and modified radical dissection of lateral lymph nodes of the neck (MRND) in patients with PTC. The special emhasys has been paid on the dissection and ligature of the superior and inferior thyroid vessels, discovering and preserving of the laryngeal reccurent nerve until the entrance in to the larynx. After dissection of central lymph nodes of the neck we have a good parathyroid glands vascularisation. MRND preserves all significant anatomic structures: sternocleidomastoid muscle, omohyoid muscle, internal jugular vein, accesory, hypoglosal and phrenical nerves, superfitial transversal cervical artery and vein.

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