Thyroidectomy: Process, Reasons And Recovery
Thyroidectomy is a surgical procedure that is performed relatively frequently. It consists of removing part or all of the thyroid gland. This is an organ that plays a leading role in regulating metabolism.
The problem is that the pathologies that affect this gland are very common in the general population. For example, Graves’ disease, goiter, or even thyroid cancer. All of them can lead to the indication of thyroidectomy.
It is considered a safe technique, but like any surgery, it is not without risks. Therefore, in this article we explain everything you need to know about the intervention and why it is performed.
What is a thyroidectomy?
Before explaining what a thyroidectomy consists of, it is essential to talk about the gland. The thyroid is a butterfly-shaped organ in the front of the neck. It is made up of two lobes that are joined together by a part that is called the isthmus .
It is responsible for secreting thyroid hormones that play a very important role in regulating metabolism. For example, they influence body temperature or caloric expenditure, among other functions.
Thyroid gland diseases are very common in the general population. Thyroidectomy, as explained by specialists from the Mayo Clinic, is a surgical procedure that removes part or all of the organ.
In this way, it is used to treat pathologies such as goiter or thyroid cancer. There are different ways of doing it, depending on the underlying disease. We will explain it later.
When is thyroidectomy necessary?
The most common cause for this intervention is thyroid cancer. There are different types of cancer, among which papillary carcinoma stands out as the most common.
All of them can benefit from this treatment if they are located in the gland and there are no metastases to other parts of the body. In addition to cancer, thyroidectomy can be helpful in treating certain cases of goiter.
Goiter is a noncancerous enlargement of the gland. When it reaches a noticeable size or grows towards the inside of the neck, it can press on some structures, such as the trachea. This causes very annoying symptoms to appear, such as difficulty swallowing or breathing.
Certain types of hyperthyroidism can benefit from thyroidectomy. It is often used in cases where medical or radioactive iodine treatment has failed. It is common in Graves disease.
Another possible indication for thyroidectomy is thyroid nodules. Not all are removed, but it is done in those people in whom it is not known whether they are benign or malignant.
Types of thyroid gland removal
Thyroidectomy can be done in different ways. According to an article by the American Thyroid Association , the choice of technique will depend on the cause of the surgery. It is a complex decision that must be made by a team of professionals.
The first classification divides the thyroidectomy into partial or total. When talking about the partial form, it is also called hemithyroidectomy . It consists of removing only half of the gland. It is useful when there are nodules located in a single lobe.
Total thyroidectomy is the removal of the entire gland. It is the most used in cases of cancer or when it is a very extensive goiter. The problem is that this technique requires subsequent medication to restore the hormones.
In addition, surgery can be classified based on the approach used to perform it. It can be conventional, transoral or endoscopic.
Conventional thyroidectomy
This technique consists of making an incision in the center of the neck. That is where the gland is located. In this way, it is removed directly, using general anesthesia.
Transoral or endoscopic thyroidectomy
This surgery allows the gland to be removed in a less invasive way. Smaller incisions are used. Surgical instruments and a small camera for observation are inserted through them. It is useful for people with high surgical risk.
It also serves to improve the aesthetic result, since so visible scars are not created. According to an article in Endocrine Surgery , there is a transoral and submental procedure that is the most useful.
The gland is removed through an incision under the chin. The scar is hidden by the shape of the chin itself. In addition, postoperative complications and the feeling of discomfort are reduced.
Preparation for the intervention
Before performing a thyroidectomy it is essential that the patient is well informed. As general anesthesia is used, it is usual that you cannot eat or drink anything in the hours before the procedure.
The doctor must know any type of treatment that the patient has. Certain drugs may need to be withdrawn earlier to avoid complications. For example, this is the case with anticoagulants.
The patient must know that, if the thyroidectomy is total, he must be under pharmacological treatment for life. By removing the gland, the body will be unable to synthesize thyroid hormones.
Recovery after the procedure
After the thyroidectomy, the patient must remain admitted to the hospital. This way you can recover from the anesthesia and the surgery itself. Furthermore, this observation period is essential to control any postoperative complications.
Neck discomfort or pain is common. It may even be that the voice is slightly disturbed or weak. This may be due to intubation during surgery or to irritation of the laryngeal nerves.
It is not necessary to fast after surgery. Even though the neck has been operated on, you can eat and drink. It is recommended to spend 10 days without doing intense activities. However, in subsequent days you can lead a normal life and even work.
Possible risks and complications of thyroidectomy
Like any other surgical procedure, thyroidectomy presents risks and can lead to complications. However, as Johns Hopkins Medicine specialists state , the risks are very low.
Bleeding or infections may appear. However, antibiotics are not usually used routinely, as the likelihood of their occurrence is considered low. Certain laryngeal nerves may be injured. This produces a voice alteration, such as hoarseness or permanent weakness.
When there is bleeding there is the possibility that the hematoma compresses the airways. It is an urgent situation, since the patient cannot breathe.
Finally, in some cases hypoparathyroidism may appear. It happens when the parathyroid glands are accidentally removed or damaged. The consequence is a loss of control of calcium in the blood.
Thyroidectomy is a safe surgery
Although there are risks or that thyroidectomy sometimes involves lifelong treatment with hormones, it is considered the technique of choice in many conditions. For example, in thyroid cancer. It is a safe intervention that increases the quality and life expectancy in many diseases.
