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PROCEDURES Thyroid Surgery

What is Thyroid Surgery

A Thyroidectomy is the surgical removal of the thyroid gland, which is located in the front of the neck. This gland releases thyroid hormone, which controls many critical functions of the body. There are generally three types of thyroid resections:

Total thyroidectomy: Removal of the entire thyroid

Total thyroidectomy may be done for various diseases, including thyroid cancer, Graves' disease, multinodular goitre, and substernal goitre. In some instances, your medical team may choose to perform a near-total thyroidectomy - a small piece of thyroid tissue is left behind around the parathyroid glands and recurrent laryngeal nerve to avoid damaging these structures. After a total thyroidectomy, patients need to take thyroid hormone replacement pills.

A Thyroid lobectomy (hemithyroidectomy): Removal of half of the thyroid

A thyroid lobectomy may be done for various diseases, including indeterminate lesions on fine needle biopsy, a toxic nodule, substernal goitre, and an enlarging thyroid nodule. 

The final report is usually ready 1 week after the operation. About 70% of patients with half of a normal thyroid gland will not require thyroid hormone replacement pills. This percentage decreases in older women and patients with a personal or family history of Hashimoto's thyroiditis, hypothyroidism, or autoimmune disease.

A Completion thyroidectomy: Removal of any remaining thyroid tissue.

Completion thyroidectomy is generally done after a thyroid lobectomy reveals cancer in the first half of the thyroid. This thyroidectomy may also be done to treat multinodular goitre or hyperthyroidism. After a completion thyroidectomy, patients will need to take thyroid hormone replacement pills.

The decision on which thyroid operation to perform depends on several factors, including the type of disease and the patient's preferences. Therefore, it is critical to work with a team of specialists to choose the correct operation for each patient.

What to expect

Before the procedure, your surgical team will order imaging and laboratory tests, including:

  • Thyroid imaging in the form of ultrasound, CT or MRI imaging.
  • Blood tests to detect your thyroid hormone levels.
  • An examination of your vocal cords using an instrument called a laryngoscope.

The surgical team may give you an antibiotic if you have a weakened immune system or any other conditions that make you prone to getting infections. In addition, you may receive medicines to reduce nausea and vomiting.

Your medical team will prescribe medications to keep thyroid hormones in balance during and after surgery for people with hyperthyroidism.

Patients can sometimes return home the same day as the surgery, but generally, people spend at least one night in the hospital. Your multidisciplinary team can observe and monitor your calcium levels.

When the thyroid gland is surgically removed, the body still requires thyroid hormone to keep vital functions in balance. Thyroid hormone replacement therapy involves taking synthetic or naturally derived thyroid hormones in pill form.