Thyroid Surgery

Thyroid surgery typically involves a thyroidectomy, the removal of all or part of a diseased thyroid gland. Removal of only part of the gland is called a partial thyroidectomy. In some cases, total thyroidectomy is necessary where the entire gland is removed. A Subtotal thyroidectomy is removal of nearly the entire gland leaving only a small amount of thyroid tissue behind.

Overview.

The thyroid gland is a butterfly-shaped gland located in front of the neck, just below the voice box or larynx. It consists of two lobes on either side connected by an isthmus. The thyroid produces hormones which are necessary for metabolism and proper functioning of the body. Disease or abnormality of this gland can result in various physiological problems.

Indications.

Thyroid surgery is usually recommended for thyroid conditions such as nodules, cysts, overproduction of hormones, cancerous and noncancerous tumors, and goiter or swelling of the thyroid that can make it difficult to swallow or breathe. To identify cancer, your doctor may perform a fine needle aspiration biopsy where a sample of thyroid tissue is obtained with the help of a thin needle and analyzed in the laboratory.

Surgical procedure.

Thyroid surgery is performed under general anesthesia. Your surgeon makes a 3 to 4-inch horizontal incision in the center of your lower neck. A single lobe, a lobe with the isthmus or the entire gland is removed through this incision. Cancer of the thyroid is usually treated by complete removal of the gland. Less aggressive cancers may be treated by removal of one of the lobes, the isthmus and a variable part of the opposite lobe. The parathyroid glands that regulate calcium as well as the recurrent laryngeal nerve that runs behind the thyroid supplying the larynx or voice box are identified and preserved as far as possible. After removal of the tissue, a small tube (catheter) is inserted at the site to drain accumulated blood and fluids. The incisions are then closed with sutures.

Post-Operative Care.

Following the surgery, you will be taken to the recovery room and monitored carefully. You will have a drain tube coming from the incision to allow drainage and prevent fluid accumulation. Your doctor will prescribe medications to help alleviate pain and discomfort. You will begin on a liquid diet the day after surgery and progress to solid foods as tolerated. The sutures are usually removed 7-10 days after surgery. Before leaving the hospital, you will be taught how to care for your incision.

Patients who have their entire thyroid gland removed will require thyroid replacement medication for life, and sometimes when just one lobe is removed.

Risks and complications.

As with all surgical procedures, thyroid surgery may be associated with certain risks and complications such as

Bleeding.

Infection.

Damage to the parathyroid glands.

Damage to nerves leading to speech and swallowing difficulties.

Thyroidectomy is a surgery performed to remove all or part of the thyroid gland as part of the treatment for thyroid conditions and thyroid cancer. Life long maintenance medication may be required depending on the type of surgery performed.