Thyroidectomy Surgery: Types, Procedure & Recovery
The surgical removal of all or some parts of the thyroid gland is known as a Thyroidectomy. The thyroid gland, located in the front of our neck, is shaped like a butterfly. It secretes hormones that regulate every part of our metabolism, from heart rate to the rate at which calories we burn.
The Thyroidectomy procedure is the primary surgical treatment method for thyroid cancer and is an important option for some thyroid conditions, such as the following:
These are a clump of thyroid cells that form in our thyroid gland. These are mostly harmless (noncancerous). However, sometimes these can produce too much thyroid hormone, causing symptoms.
It is a condition in which the thyroid produces and excretes more hormones than we require. It has many causes, and a Thyroidectomy operation is one of the treatment choices.
A goitre is a swollen thyroid gland that may or may not have thyroid nodules. If it develops large enough, it can exert pressure on our trachea or food pipe (oesophagus), making breathing more difficult.
Different Types of Thyroidectomy?
We classify Thyroidectomy surgery into two types: total Thyroidectomy and partial Thyroidectomy.
The partial type of Thyroidectomy, which involves the removal of a portion of our thyroid, includes:
Open thyroid biopsy:
The surgeon will remove one lobe (half) of the thyroid.
Surgeons conduct this procedure exclusively for small tumours in the isthmus. Here surgeon removes the thyroid tissue between the two lobes (thyroid isthmus).
The surgeon will remove a thyroid nodule directly.
In a total or near-total Thyroidectomy, the surgical removal of all or most of the thyroid tissue.
Causes of Thyroidectomy?
Sometimes, Thyroidectomy surgery is recommended for the following conditions:
- The thyroid gland is quite enlarged or dysfunctional.
- There are biopsy results that are clearly cancerous (malignant) or very suspicious.
- A nodule or goitre that is releasing too much thyroid hormone (hyperthyroidism), and it is not responsive to other treatments.
- A big nodule or goitre that is squeezing the trachea or oesophagus and makes breathing or swallowing difficult.
Risks & Complications of Thyroidectomy
Here are some risks that the surgeon will review:
Risk of bleeding:
Chance of permanent injury to the recurrent laryngeal nerve:
The likelihood of bleeding for this operation is around 1 out of every 300 people. To help reduce the chances of bleeding, most surgeons recommend stopping medicines such as aspirin or ibuprofen.
This is the nerve that helps move the vocal cords. This nerve is quite small and, unfortunately, travels between the thyroid and the windpipe right where the surgeon will be working. It can be stretched, bruised, or damaged during thyroid surgery.
Hypocalcemia is a medical condition characterized by an abnormal decrease in the level of calcium in the bloodstream. The most common symptoms of hypocalcemia include muscle cramps, spasms, and twitching, as well as numbness and tingling in the fingers and toes. In severe cases, hypocalcemia can cause convulsions and confusion.
Tracheostomy is a surgical procedure to remove all or part of the thyroid gland. However, it is considered a potential complication because the thyroid gland is located in close proximity to the trachea and larynx, and there is a risk of damage to these structures during surgery.
Diagnosis for Thyroidectomy
Depending upon the causes of Thyroidectomy, the surgeon will ask for the following tests to be done before surgery:
- Imaging tests, like an Ultrasound Scan, or CT scan, may be required to determine the exact location of the abnormal thyroid cell growth during surgery.
- In the case of a lump, a doctor may do a fine-needle aspiration (a sort of needle biopsy) to see if the cell growth is malignant or not.
- Doctors may examine patients' vocal cord function.
- Thyroid Function Test – which is done to know the levels of thyroid hormone.
Before surgery, an anesthesiologist will administer general anaesthesia to relax the muscles, relieve discomfort, and put the patient to sleep.
After you've been incapacitated, the surgeon makes a small incision in the centre of your neck. It is frequently placed in a skin fold where it will be difficult to see once the incision closes. Based on the case, a surgeon may have to remove a portion of the thyroid, most of the thyroid, or the whole thyroid.
If you have a Thyroidectomy surgery due to thyroid cancer, the surgeon may additionally check and remove the lymph nodes surrounding your thyroid. In some cases, the surgeon employs special equipment to detect vocal cord irritation during the treatment in order to prevent permanent damage.
The Thyroidectomy procedure typically takes 1 to 2 hours. Depending on the severity of the surgery, it may take more or less time.
When done, the surgeon will use stitches to close the wound (sutures).
Thyroidectomy Surgery Cost
Thyroidectomy costs between Rs. 75,000 to Rs. 90,000, including hospitalisation, surgeon's fees, and several other auxiliary services. This pricing range, however, is arbitrary and subject to vary if there are any postoperative complications are found.
Management of Thyroidectomy
Most patients stay in the hospital for 1 night and usually have no surgical drains to remove.
- Pain medications are usually only needed for a day or two.
- Taking 1-2 weeks off from a super strenuous activity like working, driving or running is generally recommended.
- Make sure not to lie around a lot. Since one will experience more pain and swelling, be active.
After surgery, the patient will usually come back to see the surgeon in a few weeks and review any pathology reports. The surgeon will go over all the information and let us know what the recommended follow-up may be.
Patients who have their entire thyroid removed must take daily thyroid hormones. The doctor will calculate the exact dosage initially based on a patient's weight, age, and size and then adjust it according to very sensitive blood tests.
Many thyroid issues, including those for which Thyroidectomy operation is recommended, will require careful follow-up, so understand the follow-up plan for optimal care.
Remember that surgeon and the team will be there in case of advice or help in the future.
What are some of the side effects of Thyroidectomy?
We may experience a painful throat, neck pain, difficulty swallowing, or a weak voice following Thyroidectomy surgery. Doctors will regulate a patient's diet for the evening of the surgery, but it should be back to normal the next day.
Is Thyroidectomy a major surgery?
Thyroidectomy is a routine yet major procedure with significant risks and potential complications. One could be able to find less invasive treatment options.
How is life after a Thyroidectomy?
After any surgery, the body needs time to recover and the incision to heal. Because of the wound and scar, the neck may feel stiff and painful for a few days. After that patient's life will be back to normal.