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Thyroidectomy

Thyroidectomy is the removal of all or part of the thyroid gland. Thyroidectomy is used to treat thyroid disorders, such as cancer, noncancerous enlargement of the thyroid (goiter) and overactive thyroid (hyperthyroidism).

Hospital Stay: Hospital Stay: 3 days
Duration: Duration: 3-4 hrs
Cost Estimate: Cost Estimate: 2250 USD - 7500 USD These are indicative prices in Indian Hospitals

Thyroid removal/Thyroidectomy may be indicated in any of the following conditions:

  • A small thyroid growth (nodule or cyst)
  • A thyroid gland that is overactive (thyrotoxicosis)
  • Cancer of the thyroid
  • Noncancerous (benign) tumors of the thyroid that are causing symptoms like hard to breathe or swallow

Surgery may be indicated if patient has an overactive thyroid gland and do not want to have radioactive iodine treatment, or cannot be treated with antithyroid medicines.

Problems with the thyroid gland

Hypothyroidism

An under-active thyroid is called hypothyroidism. The thyroid produces less thyroxine. This makes the pituitary gland send more TSH into the bloodstream to get the thyroid gland to make more hormone.

Common symptoms of hypothyroidism:

  • Weight gain
  • Feeling cold
  • Dry skin, hair, and nails
  • Feeling tired

Hyperthyroidism

An over-active thyroid is called hyperthyroidism. The thyroid gland makes too much thyroid hormone. The pituitary gland decreases the amount of TSH in the blood.

Common symptoms of hyperthyroidism:

  • Heat intolerance
  • Feeling jittery or irritable
  • Fast heart rate
  • Losing weight without dieting
  • Muscle weakness, fatigue

Nodules

Thyroid nodules can be either solid or cystic (fluid filled). Most of the time, thyroid works normally if you have nodules also. Most nodules are not cancerous. However, a sample of the cells in the nodule can be taken with a needle. This is called a fine needle aspiration. This sample will be examined to make sure there are no cancer cells.

Goiter

This is an enlargement of the thyroid gland with swelling or enlargement in the neck. It can become larger because thyroid is trying to make more thyroid hormone. Also, in hyperthyroidism the cells grow faster, which causes the thyroid to grow and make more thyroid hormone than the body needs.

Preparation:

Tests that show exactly where the abnormal thyroid growth is located are required prior to surgery. This will help the surgeon find the growth during surgery. You may have a CT scan, ultrasound, or other imaging tests.

Doctor may also do a fine needle aspiration to find out if the growth is noncancerous or cancerous. Vocal cord function may also be checked prior to surgery. You may also need thyroid medicine or iodine treatments 1 to 2 weeks before your surgery.

Before surgery, an anesthesiologist will review medical history and decide what type of anesthesia to use. The anesthesiologist is a doctor who will give you the medicines that will make you sleepy and keep you pain-free during surgery. The anesthesiologist will also monitor during surgery.

Several days to a week before surgery, you may be asked to stop taking medicines that make it harder for your blood to clot like Aspirin, Clopidogrel, Ibuprofen, Naproxen, Warfarin etc.

You will probably be asked to stop eating or drinking at some point the night before or day of surgery. Ask your doctor which medicines you should still take the day of surgery.

If you smoke, try to stop. Your recovery time will be shorter if you do not smoke.

Surgery:

Mostly the surgery will be done under general anesthesia (asleep and pain-free). In rare cases, the surgery is done with local anesthesia and medicine to relax you. You will be awake, but pain-free.

During the procedure:

  • The surgeon makes a 3- to 4-inch cut in the middle of your neck, right on top of the thyroid gland. Or, the surgeon makes a smaller cut less than 2 inches long.
  • All or part of the gland is removed through the cut.
  • The surgeon is careful not to damage the blood vessels and nerves in your neck.
  • A small tube (catheter) may be placed into the area to help drain blood and other fluids that build up. The drain will be removed in 1 or 2 days.
  • The cuts are closed with sutures (stitches).

Surgery to remove whole thyroid may take up to 3-4 hours. It may take less time if only part of the thyroid is removed.

After thyroidectomy:

After surgery, patient is moved to a recovery room where the health care team monitors recovery from the surgery and anesthesia. Once patient is fully conscious, he will be moved to a hospital room.
May have a drain under the incision in your neck. This drain is usually removed the morning after surgery.
After a thyroidectomy, patient may experience neck pain and a hoarse or weak voice. This doesn’t necessarily mean there’s permanent damage to the nerve that controls your vocal cords. These symptoms are often temporary and may be due to irritation from the breathing tube (endotracheal tube) that’s inserted into windpipe (trachea) during surgery, or as a result of nerve irritation caused by the surgery.
You’ll be able to eat and drink as usual after surgery. Most people who have thyroidectomies remain in the hospital for about 24 hours.
After going home, you can usually return to your regular activities, often within 10 days or so. Talk to your doctor about specific activity restrictions.

Complications:

Thyroidectomy is generally a safe procedure. But as with any surgery, thyroidectomy carries a risk of complications.
Outcome of this surgery is usually excellent. Most people need to take thyroid hormone pills (thyroid hormone replacement) for the rest of their lives when the whole gland is removed.

A thyroidectomy is the surgical removal of all or part of the thyroid gland.

The thyroid, located at the base of your neck, makes a hormone that is sent into your bloodstream. The thyroid gland makes this hormone from iodine. Iodine is absorbed from the foods we eat.
The thyroid hormone controls the speed of your metabolism. The pituitary gland (located in your brain) controls how much thyroid hormone to make. It does this by making thyroid stimulating hormone (TSH). TSH tells the thyroid gland to make more or less thyroid hormone.

Surgery might be necessary to remove a large goiter or nodule. Surgery might also be needed to remove a hyperthyroid gland that cannot be treated with medicine, or for thyroid cancer.

The risks of surgery are minimal, but might include:

  • Blood loss
  • Infection

In addition, an occasional patient might have transient hoarseness, but this is rarely permanent. If there is thyroid cancer, you might require additional therapy.

You will be given a general anesthesia to relax your muscles, prevent pain, and make you fall asleep.

An incision (cut) is made along a crease in the base of your neck. Your surgeon might remove part of the thyroid (lobectomy), most of the gland (subtotal), or all of the gland (total thyroidectomy).

After the surgery

  • You are usually watched in the hospital overnight.
  • You will have a cosmetically acceptable scar on the front of your neck.
  • You might be required to take thyroid hormone medication.

Call your doctor if:

  • There is swelling at the incision site
  • There is bleeding at the incision site
  • You have a fever of 101° F or higher
  • There is a redness or warmth at the incision site
  • You experience tingling in your hands, feet, or lips
  • You notice numbness or tingling in your face, hands, or lips

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