THYROID

Thyroidectomy is the surgical removal of all or part of your thyroid gland.
Variations of this procedure:

• Partial thyroidectomy – If only part of your thyroid is removed
• Complete thyroidectomy – When the entire thyroid gland is removed

Thyroidectomy is used to treat thyroid disorders such as :

• Thyroid cancer. Cancer is the most common reason for thyroidectomy. If you have thyroid cancer, removing most, if not all, of your thyroid will likely be a treatment option.
• Noncancerous enlargement of the thyroid (goiter). Removing all or part of your thyroid gland is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing or, in some cases, if the goiter is causing hyperthyroidism
• Overactive thyroid (hyperthyroidism). Hyperthyroidism is a condition in which your thyroid gland produces too much of the hormone thyroxine. If you have problems with anti-thyroid drugs and don’t want radioactive iodine therapy, thyroidectomy may be an option
• Indeterminate or suspicious thyroid nodules. Some thyroid nodules can’t be identified as cancerous or noncancerous after testing a sample from a needle biopsy. Doctors may recommend that people with these nodules have thyroidectomy if the nodules have an increased risk of being cancerous.

If you need only part of your thyroid removed (partial thyroidectomy), your thyroid may work normally after surgery. If your entire thyroid is removed (total thyroidectomy), you need daily treatment with thyroid hormone to replace your thyroid’s natural function. The amount of the thyroid that needs to be removed is decided by the reason for surgery.

Thyroidectomy is generally a safe procedure. But as with any surgery, thyroidectomy carries a risk of complications.

Potential complications include:

• Sore throat
• Bleeding
• Infection.
• Low parathyroid hormone levels (hypoparathyroidism) caused by surgical damage or removal of the parathyroid glands. These glands are located behind your thyroid and regulate blood calcium. Hypoparathyroidism can cause numbness, tingling or cramping due to low blood-calcium levels.
• Damage to the Oesophagus (food inlet) or trachea(windpipe)
• Hoarse or weak voice due to nerve damage.
•  Adhesions or scar tissue formation that may require additional surgery

You may need to avoid eating and drinking for a certain period of time before surgery, as well, to avoid anaesthesia complications. Your doctor will provide specific instructions.

Before your scheduled surgery, ask a friend or loved one to help you get home after the procedure. Be sure to leave jewellery and valuables at home
Surgeons typically perform thyroidectomy during general anaesthesia, so you won’t be conscious during the procedure. The anaesthesiologist or anaesthetist gives you an anaesthetic medication as a gas — to breathe through a mask — or injects a liquid medication into a vein. A breathing tube will then be placed in your trachea to assist breathing throughout the procedure.

The surgical team places several monitors on your body to help make sure that your heart rate, blood pressure and blood oxygen remain at safe levels throughout the procedure. These monitors include a blood pressure cuff on your arm and heart-monitor leads attached to your chest.

Once you’re unconscious, the surgeon makes a cut (incision) low in the center of your neck. It can often be placed in a skin crease where it will be difficult to see after the incision heals. All or part of the thyroid gland is then removed, depending on the reason for the surgery.

If you’re having thyroidectomy as a result of thyroid cancer, the surgeon may also examine and remove lymph nodes around your thyroid. Thyroidectomy usually takes one to two hours. It may take more or less time, depending on the extent of the surgery needed and the expertise of the operating surgeon.

There are several approaches to thyroidectomy, including:

• Conventional thyroidectomy. This approach involves making an incision in the center of your neck to directly access your thyroid gland. The majority of people will likely be candidates for this procedure.
•  Transoral thyroidectomy. This approach avoids a neck incision by using an incision inside the mouth.
• Endoscopic thyroidectomy. This approach uses smaller incisions in the neck or axilla. Surgical instruments and a small video camera are inserted through the incisions. The camera guides your surgeon through the procedure. These are more cosmetic in outcome, but can only be done in highly selective cases.

After surgery, you’re moved to a recovery room where the health care team monitors your recovery from the surgery and anaesthesia. Once you’re fully conscious, you’ll be moved to a hospital room.

Some people may need to have a drain placed under the incision in the neck. This drain is usually removed the morning after surgery.

After thyroidectomy, a few people may experience neck pain and a hoarse or weak voice. This doesn’t necessarily mean there’s permanent damage to the nerve that controls the vocal cords. These symptoms are often short-term and may be due to irritation from the breathing tube that’s inserted into the windpipe during surgery, or be a result of nerve irritation caused by the surgery.

You’ll be able to eat and drink as usual after surgery. Depending on the type of surgery you had, you may be able to go home the day of your procedure or your doctor may recommend that you stay overnight in the hospital.

When you go home, you can usually return to your regular activities. Wait at least 10 days to two weeks before doing anything vigorous, such as heavy lifting or strenuous sports.

It takes up to a year for the scar from surgery to fade. Your doctor may recommend using sunscreen to help minimize the scar from being noticeable.

The long-term effects of thyroidectomy depend on how much of the thyroid is removed.

If only part of your thyroid is removed, the remaining portion typically takes over the function of the entire thyroid gland. So you might not need thyroid hormone therapy.

If your entire thyroid is removed, your body can’t make thyroid hormone. Without replacement, you’ll develop signs and symptoms of underactive thyroid (hypothyroidism). Therefore, you’ll need to take a pill every day that contains the synthetic thyroid hormone. This hormone replacement is identical to the hormone normally made by your thyroid gland and performs all of the same functions. Your doctor will test your blood to know how much thyroid hormone replacement you need.

Thyroid cancer patients may need further treatment in the form of thyroid hormone for the TSH hormone suppression, radio – iodine therapy and sometimes radiation therapy or chemotherapy. In general, thyroid cancers have a good prognosis and people can leave healthy normal lives if they take treatment correctly and completely.