Thyroidectomy - Thyroid Removal Surgery

What Happens During a Thyroidectomy?

surgeons performing surgery
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Surgical removal of the thyroid gland is called a thyroidectomy. It is used to treat diseases and conditions such as thyroid cancer, hyperthyroidism, and an enlarged thyroid (goiter). There are times when these conditions are only improved, and not cured, with the removal of the thyroid. The thyroid is a small, butterfly-shaped gland located in the neck and functions to regulate our metabolism. (Read more about thyroid function and anatomy)

Types of Thyroidectomy Surgeries

There are a few different types of thyroidectomy surgery.

Total Thyroidectomy: removal of the entire thyroid. A total thyroidectomy is a common surgical approach when a person has thyroid cancer. It is often completely removed even when the malignant tissue is confined to only one half of the thyroid.

Subtotal or Partial Thyroidectomy: The thyroid has two lobes, one on each side of the trachea. In a partial or subtotal thyroidectomy, the surgeon removes half of the thyroid, plus the isthmus between the two lobes, and part of the other lobe. It is a common surgical approach for goiters but it is less common for thyroid cancer than performing a total thyroidectomy. 

Lobectomy: removal of the thyroid lobe. The isthmus may or or may not be removed as well. It is not a common approach for thyroid cancer, where a total thyroidectomy is usually performed.

What Happens During a Thyroidectomy

A thyroidectomy is most always performed under general anesthesia.

There are some reported cases of a thyroidectomy being performed with a spinal or local anesthetic (with sedation), but this is generally not standard practice.

An incision is made in the neck, along a natural fold of the skin to minimize scar appearance. Special care is taken to identify and prevent damage to the parathyroid glands and recurrent laryngeal nerves.

Using a scalpel and other surgical instruments, the surgeon will remove the thyroid and possibly some lymph nodes. An immediate biopsy may be done on these tissues, or they may be examined later by a pathologist for a accurate diagnosis.

Before closing the incision, drains may be placed to prevent fluid build-up. The drains will remain until drainage begins to subside. For some people this could be a day or two. Others may need longer; it varies from person to person.

After Thyroidectomy Surgery

Most people spend between one and four days in the hospital after having a thyroidectomy. You will be monitored closely after surgery to ensure you are recovering as expected. The doctor will closely watch your calcium levels, as the parathyroid glands are important for maintaining calcium blood levels in normal range.. Even if your parathyroid glands were not damaged during surgery, they can become a little sluggish after surgery and cause a decrease in the calcium levels in the blood. This is usually temporary.

If they decrease, calcium supplements will be given until the levels increase and stabilize.

Your nurse will teach you how to care for your incision and to monitor it for signs of infection. Infection is not very common with thyroid incisions, but can occur. If your surgical drain is remaining in place when you go home, you will also be taught how to care for it.

Will I Need Medication After Thyroid Surgery?

If you had a total thyroidectomy, your body will no longer be producing essential thyroid hormones. You will experience the side effects of hypothyroidism. To counteract this effect, you will be prescribed a synthetic version of thyroid hormone, such as Cytomel or Synthroid.

If you had a partial thyroidectomy, you will likely not require medication, as the remaining half of the thyroid will usually resume function. Again, this varies, and some people may require a thyroid hormone medication.

Source:

American Cancer Society. Detailed Guide: Thyroid Cancer. How is Thyroid Cancer Diagnosed?. Revised 07/20/2010.

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