What is Thyroidectomy?
Thyroidectomy is a surgical procedure in which all or part of the thyroid gland is removed. The thyroid gland, named so because of its shield-like shape, is located in front of the neck. It produces hormones that regulate metabolism and other crucial functions required by the body.
Thyroidectomy is typically performed to treat conditions such as thyroid cancer, an overactive thyroid gland (hyperthyroidism), thyroid nodules, or goiter that is causing difficulty breathing or swallowing.
What conditions require Throidectomy?
Thyroidectomy is a treatment recommendation for various disease and thyroid function deficiencies. It is also the main treatment route for thyroid cancer and thyroid related tumors. Such conditions that would require a thyroidectomy to fix include;
Thyroidectomy is the main surgical treatment for thyroid cancer and is a treatment option for certain thyroid conditions, including:
- Thyroid nodules: Thyroid nodules are lumps or growths that form on the thyroid gland. These nodules can be either solid or fluid-filled, and they can vary in size from very small to several centimeters in diameter. Thyroid nodules are usually benign (noncancerous), but they can be malignant (cancerous). Thyroid nodules at times produce excess thyroid hormone, causing a toxic thyroid nodule. Thyroidectomy can be employed as a treatment plan when this happens.
- Goiter: Goiter is an enlarged thyroid gland with or without thyroid nodules. If it grows large enough, it can put pressure on your trachea or food pipe (esophagus) and make it more difficult to breathe and swallow.
- Hyperthyroidism: Hyperthyroidism (overactive thyroid) is a condition in which your thyroid creates and releases more hormones than you need. It has several causes, and surgery is one of the treatment options for the condition.
- Thyroid Cancer: Thyroidectomy is the major treatment route for thyroid cancer. Thyroid cancer is a disease in which malignant (cancer) cells form in the tissues of the thyroid gland. These types of cancer may be papillary thyroid cancer, follicular thyroid cancer. medullary thyroid cancer (MTC), anaplastic thyroid cancer, primary thyroid lymphoma (where surgery is limited to obtaining a tissue biopsy) , and metastasis to the thyroid from cancer elsewhere in your body (most commonly renal cell cancer and lung cancer).
Other conditions where thyroidectomy as a treatment option include but are not limited to Graves Disease and multinodular goiter.
What are the types of Thyroidectomy?
There are several types of thyroidectomy:
- Total thyroidectomy: In this procedure, the entire thyroid gland is removed. This is usually done when a patient has thyroid cancer, an enlarged thyroid gland, or hyperthyroidism. After a total thyroidectomy, patients will need to take thyroid hormone replacement medication for the rest of their lives.
- Subtotal thyroidectomy: This procedure involves removing a large portion of the thyroid gland, but leaving a small amount of tissue behind. This is typically done for patients with an enlarged thyroid gland or hyperthyroidism who do not need to have the entire gland removed. However, there is a risk that the remaining tissue may continue to grow and require additional surgery in the future.
- Hemithyroidectomy: This involves removing one lobe of the thyroid gland. This is usually done when there is a nodule or tumor on one side of the thyroid gland, but the other side appears normal. After a hemithyroidectomy, patients may still have normal thyroid function because the remaining lobe can compensate for the missing tissue.
- Completion thyroidectomy: If a patient has had a hemithyroidectomy and the remaining lobe is found to be diseased, a completion thyroidectomy may be necessary to remove the entire thyroid gland.
- Total thyroidectomy with lymph node dissection: This involves removing the entire thyroid gland and any nearby lymph nodes that may be affected by thyroid cancer. This is typically done for patients with advanced thyroid cancer that has spread beyond the thyroid gland.
What is done during Thyroidectomy?
Thyroidectomy is usually done under general anesthesia which means they are unconscious during the procedure. The surgeon makes an incision in the neck to access the thyroid gland. The surgeon carefully identifies the recurrent laryngeal nerves, which are important for voice function, and the parathyroid glands, which are important for calcium metabolism, to preserve them if possible.
Depending on the reason for the thyroidectomy, the surgeon may remove only part of the thyroid gland (lobectomy or hemithyroidectomy) or the entire gland (total thyroidectomy). If the thyroid gland is cancerous, the surgeon may also remove nearby lymph nodes to check for spread of cancer.
After the thyroid gland is removed, the surgeon closes the incision with sutures or staples. The patient is then monitored closely in the recovery room for a period of time before being discharged from the hospital.
What are the complications of a Thyroidectomy?
Like any surgical procedure, thyroidectomy can be associated with potential complications. However, the overall risk of complications is relatively low, and most patients recover without any major issues.
Some potential complications of thyroidectomy include:
- Bleeding: Bleeding can occur during or after surgery and may require a blood transfusion or a return to the operating room.
- Infection: The incision site can become infected, which may require antibiotics or further surgery to treat.
- Damage to nearby structures: The recurrent laryngeal nerves or the parathyroid glands can be damaged during surgery, which can lead to hoarseness, difficulty speaking, or low calcium levels.
- Hypothyroidism: Total thyroidectomy will result in permanent hypothyroidism, which requires lifelong thyroid hormone replacement.
- Scar formation: The incision site can result in a noticeable scar, particularly in patients with a history of keloid or hypertrophic scarring.
- Recurrence: In rare cases, thyroid cancer may recur after surgery.
- Anesthesia complications: Like any surgery under general anesthesia, there is a small risk of complications related to anesthesia, such as allergic reactions, respiratory complications, or cardiac complications.
Frequently Asked Questions (FAQs)
What is the purpose of a thyroidectomy?
Thyroidectomy is the major treatment for thyroid cancer. It is however also a treatment option for conditions such as goiter, hyperthyroidism, or thyroid nodules.
What causes goiter?
Goiter is an enlargement of the thyroid gland. Goiters can be caused by;
i. Iodine deficiency as iodine is essential for thyroid hormone production. This condition is common in areas with an iodine deficiency in the soil.
ii. Hashimoto's thyroiditis: This is an autoimmune disorder in which the body's immune system attacks the thyroid gland, causing inflammation and damage. As the gland tries to compensate for the damage, it may become enlarged.
iii. Side effects of certain medications: Some medications, such as lithium or amiodarone, can cause goiter as a side effect.
iv. Pregnancy: Pregnancy can cause hormonal changes that can lead to goiter.
v. Radiation exposure: Exposure to radiation, particularly during childhood, can increase the risk of goiter.
When should I get a thyroidectomy?
After consulting with the doctor, you may be required to get a thyroidectomy in the case that;
i. You have been diagnosed with thyroid cancer.
ii. There is presence You have a nodule (growth) on your thyroid that might be thyroid cancer.
iii. You have a large nodule or goiter that’s compressing your trachea or esophagus and making it difficult to breathe or swallow.
iv. You have a nodule or goiter that’s releasing excess thyroid hormone, resulting in hyperthyroidism, and it’s not responding to other treatment options.
Would I recover after I get a thyroidectomy?
Success rate for thyroidectomy is up to 89% for total thyroidectomy and up to 91% for partial thyroidectomy according to recent research.
What happens during recovery after I get a thyroidectomy?
Patients may resume regular activities few days after the surgery. However it is advised to limit participation in physical activities or sports for a few days or weeks, or until approved by your healthcare provider.
Some patients may experience sour throats for a few days after the surgery. OTC pain relievers, such as acetaminophen or ibuprofen, can usually reduce the pain. If the pain is severe, a doctor might prescribe a stronger analgesic.
After surgery, the doctor may monitor a person’s thyroid hormone and calcium levels to check for hypothyroidism or hypoparathyroidism.
It is advised that you should notify your doctor if you are experiencing hoarseness in your voice or if you have difficulty breathing.
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