Method of Capsular Microperforation Thyroidectomy for Surgical Treatment of Giant, Retrosternal, and Other Forms of Goiter

HOW WE DO ITcompared to thyroid surgery under standard conditions.In such cases, according to literary data, the frequency of laryngeal paresis due to damage to the recurrent laryngeal nerve can reach up to 20%, and the frequency of transient and permanent hypoparathyroidism after thyroidectomy can be up to 17%. 1-7 This indicates the necessity of developing a thyroidectomy technique that improves known methods of thyroid surgery to avoid inadequacy of some technical maneuvers necessary to prevent possible complications.In terms of effective surgical treatment of substantially enlarged thyroid disease, we developed a surgical method of capsular A goiter is an enlargement of the thyroid gland that can occur for a variety of reasons.These include nodular goiters, autoimmune thyroid diseases, thyroid malignancies, and others.A certain percentage of these conditions require surgical intervention.Goiter size can vary and depend on various causes.Sometimes, goiters can reach gigantic proportions, expanding outward or inward, forming a massive retrosternal goiter.These types of goiters lead to severe complications such as strangulation syndrome, cardiovascular complications, cosmetic problems, and significantly impair the patient's quality of life.The anatomical and topographic features of the neck and upper mediastinum undergo significant changes in giant and retrosternal forms of goiter, which complicates the diagnosis and surgical treatment of these patients.The only treatment method for such patients is surgery.In turn, surgical treatment of such patients is associated with a high rate of intraoperative and postoperative complications due to difficulties with intubation anesthesia, the surgery itself, and significant thyroid enlargement, which compresses and displaces the trachea, esophagus, vessels, nerves, and other soft tissue structures of the neck and upper mediastinum.The close adhesion of thyroid tissue to adjacent structures of the neck and upper mediastinum creates significant difficulties in its mobilization during surgery.If goiter removal via a cervical approach is impossible, a sternotomy is sometimes necessary, which in turn is associated with an additional risk of postoperative complications, increased hospitalization, and increased financial costs.There is a high risk of complications such as paresis and paralysis of the recurrent laryngeal nerve, postoperative hypoparathyroidism, and intraoperative and postoperative bleeding