Thyroidectomy Procedure
Overview
Thyroidectomy is a surgery where doctors remove part or all of the thyroid gland. The thyroid, shaped like a butterfly and found in the front of the neck, makes hormones that help control metabolism. These hormones influence important body functions, such as heart rate and how the body uses energy.
Doctors choose this surgical procedure for different thyroid issues. Common reasons include thyroid cancer, large noncancerous growths (goiters), and an overly active thyroid (hyperthyroidism).
Types of Thyroidectomy:
| Type | Part Removed | Effects |
|---|---|---|
| Partial Thyroidectomy | Only a portion | Thyroid function may remain |
| Total Thyroidectomy | Entire gland | Requires daily hormone replacement |
The amount of the thyroid removed depends on the specific condition being treated. After a total thyroidectomy, individuals need lifelong hormone therapy to maintain healthy body functions.
Reasons for Removing Part or All of the Thyroid
Doctors might suggest thyroid removal surgery for several medical reasons. The most common cause is thyroid cancer. Different types of cancer that may lead to surgery include:
| Cancer Types | Description |
|---|---|
| Papillary thyroid cancer | Most common, usually grows slowly |
| Follicular thyroid cancer | Can spread to other parts of the body |
| Medullary thyroid cancer | Rare, sometimes runs in families |
| Anaplastic thyroid cancer | Fast-growing, difficult to treat |
Surgeons also remove the thyroid for noncancerous conditions. Goiters, which are enlarged thyroid glands, might press on the windpipe or esophagus, making breathing or swallowing hard. Removal can improve these symptoms.
Doctors may also remove the thyroid if thyroid nodules or cysts cannot be confirmed as cancerous or benign after testing. If there is a higher risk for cancer, they may remove the thyroid as a precaution.
People with hyperthyroidism, where the thyroid is overactive, may need surgery, especially if other treatments like medicine or radioactive iodine aren’t good choices. Both benign and cancerous thyroid conditions may make surgery necessary if other treatments do not work or are unsafe.
Possible Problems
Thyroid surgery can cause a few problems, though most people recover with no issues. Bleeding near the incision site might block the airway and make breathing difficult. There is a chance of infection where the cut was made. Some may notice swelling, numbness, or tingling after surgery.
If the parathyroid glands are harmed, low blood calcium levels (hypoparathyroidism) can occur, which may cause muscle cramps. Injury to the laryngeal nerves might affect the larynx and vocal cords, leading to a hoarse voice or lasting voice changes. Risks from general anesthesia include rare but possible serious complications.
Getting Ready for Surgery
Medicines and What to Eat
Doctors may prescribe special medicine like an iodine and potassium mix if the thyroid is too active. This medicine helps manage hormone levels and lowers bleeding chances. Before surgery, most people must stop eating and drinking for a set time. This keeps anesthesia safe. Check with your doctor for the exact time.
Tip: You might get blood tests done and may need to check vitamin D levels.
Extra Steps to Take
- Ask someone to go with you and take you home after surgery.
- Leave jewelry and other valuables at home.
- Shower or bathe before coming in, but do not use lotion, perfume, deodorant, or nail polish.
What You Can Expect
Getting Ready for Surgery
Before the operation, the anesthesiologist gives the patient general anesthesia, ensuring they are fully asleep and feel no pain. The team may deliver the medication through a mask to breathe in or inject it through an IV. Once the patient is unconscious, the medical team places a breathing tube in the trachea to help with breathing during the surgery.
The medical staff attaches several monitors to check important body functions. These usually include a blood pressure cuff, heart monitor pads, and a sensor for measuring oxygen levels. All of these steps help keep the patient safe during the procedure.
What Happens in the Operating Room
The surgeon makes a small cut at the lower part of the neck, usually in a crease, so the scar is less visible later. The amount of thyroid gland removed depends on the patient’s health issue. Sometimes, the surgeon removes just part of the thyroid, but in other cases, the entire gland is taken out. There are a few ways to perform this surgery:
| Surgical Method | Description |
|---|---|
| Open Surgery | Usually involves a direct cut in the neck for access to the thyroid. |
| Endoscopic Surgery | Uses small incisions and a camera to guide the surgeon. |
| Transoral Approach | Reaches the thyroid through the mouth for less visible scars. |
If thyroid cancer is present, the surgeon may remove nearby lymph nodes. To protect the patient’s voice, special equipment can help the doctor check the vocal cords during the procedure. Most thyroid surgeries last between 1 and 2 hours, but the exact time can change based on what the surgeon finds.
Recovery and Care After Surgery
After surgery, nurses monitor patients in a recovery area as the effects of anesthesia wear off. Some people may have a thin tube, called a drain, placed under the skin to collect extra fluid; staff usually remove this the following day.
Common issues after thyroid surgery can include a sore neck, mild pain, or a weak voice. The weak voice and neck discomfort often come from the breathing tube or nerves affected during surgery, but these symptoms usually improve within days or weeks. Occasionally, some patients will have lasting hoarseness if the vocal cords are affected.
Eating and drinking are usually possible soon after waking up. Depending on the procedure, a patient might go home the same day, or stay one night in the hospital. For safe healing, patients should:
- Avoid heavy lifting or strenuous activity, such as sports, for about 10 to 14 days.
- Keep the neck incision clean and dry. Showering is allowed, but patients should follow any wound care instructions.
- Protect the scar from the sun by using sunscreen to help it fade.
- Watch out for any unusual symptoms and follow up with the doctor as planned.
Getting back to normal activities can happen within days, but it may take up to a year for the scar to fade fully. Follow-up appointments help ensure good healing.
Findings
Removal of Part of the Thyroid
When surgeons remove only part of the thyroid gland (such as with a lobectomy or hemithyroidectomy), the rest of the gland usually keeps working. Most people do not need to take thyroid hormone pills after partial removal. The remaining thyroid tissue often maintains normal hormone levels, so metabolism and energy balance continue as before.
Possible Outcomes
- No need for thyroid hormone replacement.
- Normal calcium levels since parathyroid glands are usually not affected.
- Lower risk of permanent hypothyroidism.
Removal of the Entire Thyroid Gland
When surgeons remove the complete thyroid (sometimes called a total or completion thyroidectomy), the body cannot make thyroid hormone anymore. People will need to take a daily synthetic hormone tablet like thyroxine to replace what the gland made. Blood tests help find the right dose.
| Factor | Result After Complete Removal |
|---|---|
| Thyroid hormone production | Stops completely |
| Treatment needed | Daily thyroid hormone pill |
| Hormone levels | Monitored and adjusted as needed |
| Metabolism | Controlled by medicine |
| Calcium and parathyroid risk | May be affected; calcium levels checked |
