Treatment of thyroid tumor can have both fish and bear's paw-- Interview with Professor Fan Youben, chief physician, Department of general s
Treatment of thyroid tumor can have both fish and bear's paw
-- Interview with Professor Fan Youben, chief physician, Department of general surgery, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University
Health wealth newspaper reporter Li Lin
More than and 30 year old Liu, is a white-collar workers, the colleague reminds found his neck actually grow a man some "Adam's apple". Because Ms. Liu often need to deal with customers, so the "Adam's apple" affects the confidence and the girl Liu more or less influence on work. Ms. Liu to the hospital for diagnosis of thyroid nodules, the diameter of 87.5px. When you know that if you want to eliminate the need for surgical treatment of nodules, which makes Ms. Liu is very tangled, she wants to eliminate the beauty of thyroid nodules but do not want to leave a scar.
When Liu learned that Shanghai hospital director Fan Youben has a deep research on thyroid surgery, especially to find director fan. Fan Liu introduced to the director of minimally invasive video-assisted thyroidectomy via breast and thyroid surgery, single hole by Chin single hole thyroid surgery, oral thyroid surgery as its choice, because the endoscope assisted thyroid surgery and submental neck incision thyroid surgery is still small, so Liu first ruled out of the two operation. In two other operation, Liu felt by mouth after thyroidectomy on no scar, and small surgical trauma, so Ms. Liu chose after thyroid surgery. The operation lasted 1.5 hours and was discharged on the third day after operation. There is no scar on the body surface, the mouth is not significantly affected, Ms. Liu is very satisfied with the results of surgery.
The surgeon's hand can help many patients recover and save their lives. Today, more surgeons recognize that while saving, but also more care about the quality of life of patients after surgery. Because the thyroid gland in the neck, a lot of patients with thyroid disease in the postoperative neck will leave a more prominent scar, leaving a beautiful regret. Therefore, the friends of the fan director said, in order to ensure the treatment effect, and can keep the appearance of patients, thyroid minimally invasive surgery has been explored, and in the surgical treatment of thyroid nodules on the field has made "fish and bear's paw" - effect and beauty both achievement.
Four strokes of thyroid mass
The thyroid gland is shaped like a butterfly, attached to the front and sides of the trachea, and moves up and down with swallowing. But the normal thyroid can not see, it is difficult to touch.
Fan director pointed out that the thyroid tumor (or nodules) volume is small, no obvious symptoms, easy to be ignored. If not timely diagnosis and treatment, may gradually increase, when severe breathing difficulties, dysphagia and hoarseness and other symptoms, and even cancer. The thyroid gland is located in the front of the exposed neck, and the neck is the most common thyroid nodules, therefore, can be checked by self concern, help early detection of thyroid changes.
A look at the shape of the mass. As a butterfly increases, symmetrical uniform enlargement, this part is common in thyroiditis and hyperthyroidism patients (such as accompanied by palpitation, sweating, weight loss; or weakness, cold, swelling, blood abnormalities of thyroid function tests); the other is a round mass appeared in certain parts of the thyroid the more common in thyroid cyst, thyroid adenoma, nodular goiter, including thyroid cancer.
Two touch the smoothness and hardness of the tumor. If the mass is smooth and uniform, or more, the texture is soft and may cross adenoma or nodular goiter; not smooth, the boundary is not clear, hard texture and single, should be more suspicious for cancer.
Three to determine the growth rate of mass. Benign tumors are slow growing and malignant tumors grow rapidly, but thyroid cancer (except for the most poorly differentiated cancer) is slower than that of hcc. Benign tumors and cysts can grow from a few months to several years, or even decades, but if within a few days or a month, swelling suddenly increased significantly, which may be the liquefaction of adenoma bleeding. Such as the gradual increase in the size of the tumor, with other related features to be suspected of thyroid cancer.
Four touch lumps around lymph nodes. If in the thyroid tumor ipsilateral neck can touch the hard texture of lymph nodes, lymph node metastasis may occur, should pay attention to, rapid treatment.
Diagnosis of thyroid mass
Fan said that the above situation, do not need to worry too much, because both benign and malignant thyroid nodules, the development is relatively slow, the most reasonable professional treatment, good prognosis. By ultrasound (defense of benign and malignant thyroid function tests (blood) and hyperthyroidism, hypothyroidism, defense or Hashimoto's thyroiditis) can be diagnosed. Fine needle aspiration cytology can also be done, for some cases diagnosed.
Fan director pointed out that the high clear thyroid ultrasonography is found more sensitive to thyroid nodules more specific, more convenient, inexpensive and noninvasive method. At the same time, it can be used to judge the nature of nodules, and can also be used to locate, puncture, treat and follow up the thyroid nodules under the guidance of ultrasound. Therefore, all patients with suspected thyroid nodules should be performed thyroid ultrasound examination, physical examination found thyroid nodules patients also need to do this routine examination. Thyroid scintigraphy (ECT) is the only method to evaluate the functional status of nodules. According to the radionuclide uptake ability, the nodules can be divided into "hot nodules", "warm nodules", "cool nodules" and "cold nodules"". This method is only used for ectopic thyroid gland, or thyroid nodules complicated with hyperthyroidism or subclinical hyperthyroidism, in order to determine whether the nodules are hot nodules". CT and MRI are not as sensitive as thyroid ultrasound in the detection of thyroid nodules and the judgment of nodule properties. However, it is essential to evaluate the relationship between thyroid nodules and the surrounding tissues, especially in the treatment of post sternal goiter, or locally advanced thyroid cancer.
Thyroid fine needle aspiration cytology (FNAC) is the most reliable and valuable diagnostic method for the diagnosis of benign and malignant nodules, with a sensitivity of 83%, specificity of 92%, and accuracy of 95%. Suspicious malignancy should be FNAC.
Surgical treatment of thyroid diseases
Patients with thyroid mass, how to treat it? Fan director said that the change of thyroid function, through drug treatment has good effect on the human body, make the "transmission" to restore normal metabolism. No specific treatment of thyroiditis. Thyroid cancer, especially large, or suspected lymph node metastasis early thorough reasonable surgical treatment, postoperative thyroid hormone suppression therapy, if necessary, with 131 iodine adjuvant therapy, so as not to invade surrounding organs, hoarseness, tracheo esophageal vascular invasion, or transferred to the body organs such as lung and bone. Unlike stomach cancer, liver cancer and pancreatic cancer, differentiated thyroid cancer is not sensitive to radiotherapy and chemotherapy. For benign multiple small nodular goiter, surgical indications strictly, to follow-up.
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