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Thyroidectomy (thyroid gland removal)

What is the thyroid gland?

What is thyroid gland?
What is thyroid gland?

The thyroid gland is a butterfly-shaped organ located below your Adam’s apple, along the front of your windpipe. It has two side lobes connected by a bridge called isthmus in the middle. At its normal size, the thyroid gland cannot be felt.

The main function of the thyroid gland is to produce hormones which regulate metabolism. It is also responsible for keeping the organs of the body functioning properly and helping the body conserve heat.

Thyroid diseases can cause the thyroid gland to become enlarged, obstructing the throat and causing various symptoms.

When is it necessary to remove the thyroid gland?

Surgery is usually needed when suspicious nodules or swelling appear. These symptoms can be associated with disorders such as cancer or a noncancerous enlargement of the thyroid (goiter). An overactive thyroid gland (hyperthyroidism) which produces too much of the hormone thyroxine can also be treated with thyroidectomy when anti-thyroid drugs or radioactive iodine therapy are not an option for some reason.

What exactly is removed during a thyroidectomy?

  • Partial thyroid gland removal
    When a nodule, inflammation, or swelling affects only one side of the thyroid gland, doctors usually remove only one of the two lobes (thyroid lobectomy). The part left behind should retain some or all of its function.
  • Near total (subtotal) thyroid removal
    A subtotal thyroidectomy removes the thyroid gland but leaves behind some thyroid tissue to preserve a degree of thyroid function. Many individuals who undergo this type of surgery develop hypothyroidism, a condition which occurs when the thyroid galnd doesn’t produce enough hormones. They can easily be supplemented with a daily dose of thyroid hormone.
  • Total thyroidectomy
    A total thyroidectomy removes the entire thyroid gland including all thyroid tissue. This surgery is appropriate when nodules, swelling, or inflammation affect the entire thyroid gland, or when cancer is present. If your entire thyroid gland is removed, you will need a daily dose of thyroid hormone supplement for the rest of your life to replace the hormones previously produced by your thyroid gland.

How is the surgery performed?

Whether partial or total, thyroidectomy is performed under general anaesthesia. It is important not to eat or drink anything prior to your surgery.

Your surgeon will make an incision on the front of your neck, over the thyroid gland and carefully remove all or part of the gland. Because the thyroid is small and surrounded by nerves and glands, the procedure may take two hours or more.

What are the risks and benefits of the operation?

Surgery to remove the thyroid gland is well tolerated by most patients and has low complication rates. The aim of the surgery is to bring symptom relief and to prevent the development of potentially serious conditions.
Similarly to other major surgeries, thyroidectomy carries the risk of an adverse reaction to the general anesthetic. Other risks include infection, bleeding, and a permanently weak or hoarse voice. Some patients develop hypoparathyroidism as a complication.

Am I a good candidate for thyroidectomy?

A total thyroidectomy is the only solution which gives patients immediate relief from the symptoms of hyperthyroidism. Another case when surgery is the only viable option is when hyperthyroidism is caused by a so-called hot nodule. A hot nodule (also known as a toxic nodule) is best described as a thyroid nodule in overdrive producing excess thyroid hormone. This happens when a nodule doesn’t obey the pituitary gland’s signals to stop producing thyroid, resulting in hyperthyroidism. Depending on the location of the nodule, the surgeon can remove the lobe that contains the hot nodule. This leaves part of your thyroid intact, which will usually be enough to supply your body with healthy amounts of hormones.

Please note that at Medicover Hospital we do not operate on cancerous enlargements of the thyroid gland.

How to prepare for the surgery?

It is very important that thyroid function be properly regulated. Therefore, you and your endocrinologist will work closely together to set your thyroid to healthy levels prior to the operation.

What to expect after surgery?

A day after the surgery the drain will be removed from your neck. A blood test will be performed to determine your blood calcium levels.
After the surgery you will most likely need to take a daily dose of thyroid hormone in order to replace the hormones normally produced by your thyroid gland and keep your body working properly. It may take several appointments and repeated blood tests to adjust your hormone levels and determine the appropriate dosage of your medication.

Why is regular follow-up important after thyroidectomy?

Regular post-operative follow-ups are very important to make sure your metabolism is working properly. Your doctor will be closely monitoring the dosage of your medication. He or she might make adjustments if necessary.