Algorithm of stepwise medical rehabilitation of patients with differentiated thyroid cancer

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Abstract

Four stages of medical rehabilitation of patients with differentiated thyroid cancer in Russia are described. Specific rehabilitation programs and methods are described for every stage. The pre-rehabilitation program includes psychological and nutritional support, exercise therapy, consultations by the surgeon and anesthesiologist, correction of concomitant disorders, prevention of thromboembolic complications and local hemodynamic abnormalities. At the rehabilitation stage in the ICU antibacterial therapy, patient positioning, percussion massage of the chest, passive mobilization, massage of the extremities are performed. The rehabilitation program at the specialized surgical department includes psychological rehabilitation, adequate pain management, exercise therapy, massage, nutritional support, prevention of thromboembolic complications, treatment of early postoperative complications. The in-hospital rehabilitation at medical facilities additionally includes treatment of delayed and late surgical complications, correction of radioiodine therapy consequences. The outpatient rehabilitation program also involves correction of hypothyroidism and minimization of adverse effects of suppressive hormone therapy, health resort treatment.

About the authors

T. I. Grushina

Moscow Research and Practical Centre of Medical Rehabilitation, Restorative and Sports Medicine, Moscow Healthcare Department

Author for correspondence.
Email: tgrushina@gmail.com
ORCID iD: 0000-0002-0945-4266

53 Zemlyanoy Val, Moscow 105120

Russian Federation

S. O. Podvyaznikov

Russian Medical Academy of Continuing Professional Education, Ministry of Health of of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0003-1341-0765

2/1 Barricadnaya St., 123995Moscow

Russian Federation

G. A. Tkachenko

Central Clinical Hospital with polyclinic of the Office of the President of the Russian Federation

Email: fake@neicon.ru
ORCID iD: 0000-0002-5793-7529

15 Timoshenko St., 121359 Moscow

Russian Federation

A. M. Mudunov

Clinical Hospital Lapino

Email: fake@neicon.ru
ORCID iD: 0000-0003-1255-5700

1111st Uspenskoe Hwy, Lapino 143081, Odintsovo City District, Moscow Region

Russian Federation

S. B. Shakhsuvaryan

Federal Bureau of Medical and Social Expertise, Ministry of Labor of Russia

Email: fake@neicon.ru

3 Ivan Susanin St., Moscow 127486

Russian Federation

Yu. V. Alymov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0002-6851-9867

24 Kashirskoe Hwy, Moscow 115478

Russian Federation

A. V. Ignatov

Russian Medical Academy of Continuing Professional Education, Ministry of Health of of Russia; RUDN University

Email: fake@neicon.ru
ORCID iD: 0000-0002-6796-0968

2/1 Barricadnaya St., 123995Moscow; 6 Miklukho-Maklaya St., Moscow 117198

Russian Federation

References

  1. Arends J., Bachmann P., Baracos V. et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017;36(1):11 —48. doi: 10.1016/j.clnu.2016.07.015.
  2. Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications (VTEO). Moscow, 2015. 51 p. Flebologiya = Phlebology 2015;4(2):148—240. (In Russ.).
  3. Gorchak Yu.Yu., Stakhanov M.L., Gens G.P. et al. Low-intensity laser radiation in the correction of postoperative hemodynamic and rheological disorders after surgical intervention for head and neck tumors. Sibirsky onkologicheskii zhurnal = Siberian Journal of Oncology 2020;19(5):28—34. doi: 10.21294/1814-4861-2020-19-5-28-34. (In Russ.).
  4. Cirocchi R., Arezzo A., D’Andrea V. et al. Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery. Cochrane Database Syst Rev 2019. doi: 10.1002/14651858.cd012483.pub2.
  5. Romanchishen A.F., Vabalaite K.V., Romanchishen FA. Advantages of neuromonitoring of accessory nerves in patients with thyroid cancer with regional metastases. Golova i sheya = Head and neck 2020;8(S2):53. (In Russ.).
  6. Chandrasekhar S.S., Randolph G.W., Seidman M.D. et al. Clinical practice guideline: improving voice outcomes after thyroid surgery. Otolaryngol Head Neck Surg 2013;148(6 Suppl):S1—37. doi: 10.1177/0194599813487301.
  7. Filonenko E.V., Golubtsov A.K., Kirpa E.A., Reshetov I.V. Rehabilitation of patients with thyroid cancer. IV Inter- 14. national Congress “Head and Neck (In Russ.).
  8. Dolidze D.D., Podvyaznikov S.O., Melnik K.V. et al. Features of intraoperative visualization of the parathyroid glands in the surgical treatment of patients with thyroid carcinoma. Opukholi golovy i shei = Head and Neck Tumors 2018;Special Issue:19—20. (In Russ.).
  9. Golub I.E., Pinsky S.B., Kolbaseeva O.V., Ivankova E.N. Anesthesiological support during operations on the thyroid gland. Sibirskii meditsinskii zhurnal = Siberian Medical Journal 2011;100(1):93—95. (In Russ.).
  10. Osipova N.A., Reshetov I.V. Problems of anesthesiological support in surgery of head and neck tumors (lecture). Anesteziologiya i rea-nimatologiya = Anesthesiology and Resuscitation 2017;62(1):51—3. (In Russ.). doi: 10.18821/0201-7563-2017-62-1-51-53.
  11. National Comprehensive Cancer Network (NCCN), Head and Neck Cancers, Version 1.2021, 11.09.2020.
  12. Potapov A.L., Khoronenko V.E., Gameeva E.V. et al. Additional oral nutrition: applied classification of mixtures and key rules of application in oncology. Voprosy pitaniya = Nutrition Issues 2020;89(1):69—76. (In Russ.). doi: 10.24411/0042-8833-2020-10008.
  13. Fedotkina Yu.A. Prevention of venous thromboembolic complications in cancer patients. Aterotromboz = Atherothrombosis 2019;1:8-24. (In Russ.). doi: 10.21518/2307-1109-2019-1-8-24.
  14. Khnzli B.M., Walensi M., Wlimsky J. et al. Impact of drains on nausea and vomiting after thyroid and parathyroid surgery: a randomized controlled trial. Langenbecks Arch Surg 2019;404(6):693— 701. doi: 10.1007/s00423-019-01799-6.
  15. Kovatch K.J., Reyes-Gastelum D., Hughes D.T. et al. Assessment of voice outcomes following surgery for thyroid cancer. JAMA Otolaryngol Head Neck Surg 2019:e191737. doi: 10.1001/jamaoto.2019.1737.
  16. Clinical recommendations. Paresis and paralysis of the larynx. M., 2016. 24 p. (In Russ.).
  17. Kirasirova E.A., Lafutkina N.V., Mamedov R.F. et al. Tactics of examination and treatment of patients with paresis or laryngeal paralysis of various etiologies. Russky Meitsinsky Zhurnal = Russian Medical Journal 2013;21(11):564—7. (In Russ.).
  18. Aynehchi B.B., McCoul E.D., Sunda-ram K. Systematic review of laryngeal reinnervation techniques. Otolaryngol Head Neck Surg 2010;143(6):749—59. doi: 10.1016/j.otohns.2010.09.031.
  19. Choinzonov E.L., Balatskaya L.N., Chizhevskaya S.Yu. et al. Voice rehabilitation of patients with unilateral laryngeal paresis after surgical treatment of thyroid cancer. Problemy endokrinolodii = Problems of Endocrinology 2018;64(6):356—2. doi: 10.14341/probl9589. (In Russ.).
  20. Mokrysheva N.G., Eremkina A.K., Kovaleva E.V. Hypoparathyroidism: etiology, clinical picture, modern methods of diagnosis and treatment. Almanakh klinicheskoi meditsiny = Almanac of Clinical Medicine 2016;44(4):477—92. (In Russ.). doi: 10.18786/2072-0505-2016-44-4-477-492.
  21. Parshin V.D., Vyzhigina M.A., Bunya-tyan A.A. et al. Treatment of chylotho-rax — an anesthesiological or surgical problem? Anesteziologiya i reani-matologoya = Anesthesiology and resuscitation 20)17;62(1):63—8. (In Russ.). doi: 10.18821/0201-7563-2017-62-1-63-68.
  22. Veber V.R., Kopina M.N. Endocrinology. M.: Yurayt, 2020. 391 p. (In Russ.).
  23. Lee J.S., Kim J.P., Ryu J.S., Woo S.H. Effect of wound massage on neck discomfort and voice changes after thyroidectomy. Surgery 2018;164(5):965—71. doi: 10.1016/j.surg.2018.05.029.
  24. Stepanova Yu.E., Gotovyakhina T.V., Makhotkina N.N., Mokhotaeva M.V. Possibilities of medical and pedagogical rehabilitation of patients with unilateral laryngeal paresis. Russky Meitsinsky Zhurnal = Russian Medical Journal 2017;25(23):1712—16. (In Russ.).
  25. Iorio O., Petrozza V., De Gori A. et al. Parathyroid Autotransplantation During thyroid Surgery. Where we are? A Systematic review on indications and results. J Invest Surg 2019;32(7):594—601. doi: 10.1080/08941939.2018.1441344.
  26. Gulyaev V.A., Khubutiya M.Sh., Novruzbekov M.S. et al. Xenotransplantation: history, problems and prospects of development. Transplantologiya = Transplantology 2019;11(1):37—54. doi: 10.23873/2074-0506-2019-11-1-37-54. (In Russ.).
  27. Tyker A., Franco J., Massa S.T. et al. Treatment for lymphedema following head and neck cancer therapy: a systematic review. Am J Otolaryngol 2019;40(5):761 —69. doi: 10.1016/j.amjoto.2019.05.024.
  28. McLaughlin T.M., Broadhurst J.J., Harris C.J. et al. A randomized pilot study on self-management in head and neck lymphedema. Laryngoscope Investig Otolaryngol 2020;5(5):879—89. doi: 10.1002/lio2.455.
  29. Mayrovitz H.N., Ryan S., Hartman J.M. Usability of advanced pneumatic compression to treat cancer-related head and neck lymphedema: A feasibility study. Head Neck 2018;40(1):137—43. doi: 10.1002/hed.24995.
  30. Gutierrez C., Mayrovitz H.N., Naqvi S.H.S., Karni R.J. Longitudinal effects of a novel advanced pneumatic compression device on patient-reported outcomes in the management of cancer-related head and neck lymphedema: a preliminary report. Head Neck 2020;42(8):1791 —9. doi: 10.1002/hed.26110.
  31. Stenko A.G., Shmatova A.A., Kruglova L.S. et al. Strategy of an integrated approach to the treatment of scar lesions of the skin of the face and neck. Rossiisky zhurnal kozhnykh i venericheskikh boleznei = Russian Journal of Skin and Venereal Diseases 2013;2:49-55. (In Russ.).
  32. Singh Ospina N., Castaneda-Guarderas A., Hamidi O. et al. Weight changes after thyroid surgery for patients with benign thyroid nodules and thyroid cancer: population-based study and systematic review and meta-analysis. Thyroid 2018;28(5):639—49. doi: 10.1089/thy.2017.0216.
  33. Garbuzov P.I. Side effects and risks of radioiodine therapy for differentiated thyroid cancer. In: IV International Congress “Head and Neck Tumors”, “Baikal-2011”. P. 68. (In Russ.).
  34. Son S.H., Lee C.H., Jung J.H. et al. The preventive effect of parotid gland massage on salivary gland dysfunction during high-dose radioactive iodine therapy for differentiated thyroid cancer: a randomized clinical trial. Clin Nucl Med 2019;44(8):625—33. doi: 10.1097/RLU.0000000000002602.
  35. Rumyantsev P.O., Korenev S.V., Rumyantseva U.V. Modern principles of levothyroxine therapy after surgery in patients with highly differentiated thyroid cancer. Opukholi golovy i shei = Head and neck tumors 2013;2:5-9. (In Russ.).
  36. WHO guidelines on physical activity and sedentary behaviour: Web Annex. Evidence profiles. Geneva: World Health Organization, 2020.

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