Year 2022 Vol. 30 No 6

SCIENTIFIC PUBLICATIONS

JU.V. IVANOV 1, I.A. LOMAKIN 2, E.I. KOLBENEV 3, E.A. EPIFANCEV 1, A.I. ZLOBIN 1

THE SPECIFICITY OF PLANNING AND PERFORMING SURGICAL OPERATIONS FOR CERVICO-STERNAL LOCALIZATION IF NODULAR GOITER

Federal State Budgetary Institution "Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies" of the Federal Medical and Biological Agency of Russia 1, Moscow,
FSBEI 72 Central polyclinic of the Ministry of Emergencies of Russia 2, Moscow,
Remsi Diagnostics Rus LLC 3, St. Petersburg,
Russian Federation

To evaluate the results of surgical treatment of patients (n=87) with substernal goiter. The main emphasis was done on the application of multislice spiral three-dimensional computed tomography reconstruction
With the volume of the retrograde component of the thyroid gland up to 100 cm3, it is preferable to perform the operation through the cervical approach, even without crossing the prethyroid muscles, with the volume from 100 to 150 cm3 - cervical access with the intersection of the prethyroid muscles, and with the retrograde component more than 150 cm3 - combined access.
The main risk factor for the expansion of surgical access from cervical to combined is the volume of the retrograde component of the thyroid gland more than 150 cm3. The use of the ultracision Harmonic Scalpel Neurosan-400 complex, the magnifying optics by an operating surgeon during surgery can improve the safety of surgery and significantly reduces the risk of intraoperative complications, primarily: bleeding, recurrent laryngeal nerve injury, identification of inadvertently removed parathyroid glands.
Preoperative (3-4 days) X-ray endovascular occlusion of the thyroid arteries allows significantly reducing the arterial blood flow to the gland, followed by a decrease of its volume, which leads to a reduction of intraoperative blood loss, facilitates the operation technique, to shorten the actual operating time.
For the safe and effective treatment of patients with substernal goiter, the clinic should have a multidisciplinary team of specialists for surgery.

Keywords: journal goiter, multispiral computed tomography, combined operative access, X-ray endovascular occlusion
p. 501-509 of the original issue
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Address for correspondence:
115682, Russian Federation,
Moscow, Orekhovy Blvd, 28
Federal Scientific and Clinical Center
for Specialized Types of
Medical Care and Medical Technologies
of the Federal Medical-Biological Agency of Russia,
tel.: +7 926 520 70 62,
e-mail: Sancho-83@inbox.ru,
Zlobin Alexander I.
Information about the authors:
Ivanov Yury V., MD, Professor, Honored Doctor of the Russian Federation, Head of the Department of Surgery, Federal State Budgetary Institution Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies FMBA of Russia, Moscow, Russian Federation,
https://orcid.org/0000-0001-6209-4194
Lomakin Ivan A., surgeon, Federal State Budgetary Educational Institution 72 Central Polyclinic of the Ministry of Emergency Situations of the Russian Federation, Moscow, Russian Federation.
https://orsid.org/0000-0002-9734-7507
Kolbenev Evgeniy I., Department of Radiation Diagnostics, Ramsey Diagnostics Rus LLC, Radiologist. Moscow, Russian Federation.
https://orcid.org/0000-0002-6516-0529
Epifantsev Evgeniy A., Surgeon, Department of Surgery, Federal State Budgetary Institution Federal Research and Clinical Center for Specialized Types of Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russian Federation.
https://orcid.org/0000-0001-9768-7440
Zlobin Aleksandr I., PhD, Surgeon, Department of Surgery, Federal State Budgetary Institution Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russian Federation
https://orcid.org/0000-0002-8241-659X
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