Thyroidectomy

Who is a candidate for a thyroidectomy

A thyroidectomy is most commonly performed to treat thyroid cancer. If you have thyroid cancer, your surgeon will likely remove the entire thyroid gland. You may also be a candidate for a thyroidectomy if you have one of the following conditions:

• Enlarged thyroid (noncancerous) – If you have an enlarged thyroid, also known as goiter, it can obstruct your airway, making it hard to breathe or swallow.
• Hyperthyroidism – Hyperthyroidism is a condition where your thyroid produces too many hormones, which can accelerate your metabolism and lead to sudden weight loss, rapid heartbeat or frequent nervousness or irritability.

Risks associated with a thyroidectomy

A thyroidectomy is a major surgery, so complications can arise. Complications may include:

• Bleeding – Although not common, bleeding is the most common side effect from a thyroidectomy.
• Obstructed airway – If you are bleeding from the procedure, this could also lead to an obstructed airway.
• Low calcium – If the parathyroid glands that lie behind the thyroid gland are injured in the surgery, it may result in hypoparathyroidism. Hypoparathyroidism is a condition that can result in abnormally low calcium levels. If this occurs, you may need to take calcium and vitamin D supplements.
• Nerve damage to the laryngeal nerve – The laryngeal nerve controls the vocal cords. If injured, you may experience temporary or permanent hoarseness.

What to expect during a thyroidectomy

A thyroidectomy is performed under general anesthesia in a hospital operating room. The location of your incisions will depend on what type of procedure you are having. Once the surgical instruments are in position, your surgeon will remove part of or the entire thyroid gland. Your doctor may also remove the lymph nodes around the thyroid to determine if the cancer has spread.

The entire procedure takes approximately two to four hours, depending on the technique your surgeon is using.

There are three common types of thyroidectomy:

Conventional thyroidectomy

During a conventional thyroidectomy, your surgeon will make an incision in the center of the neck to access your thyroid gland. Your incision will be approximately one to two inches in length and made in the middle of the neck along the normal skin crease. This area is an ideal location to minimize the visibility of any scars.

Endoscopic thyroidectomy

An endoscopic thyroidectomy uses surgical instruments and a video camera inserted through smaller incisions in the neck. This is a minimally-invasive technique that can lead to faster recovery, shorter hospital stays and fewer complications.

Robotic thyroidectomy

A robotic thyroidectomy is performed either via incisions in the chest and armpit or through a smaller incision higher in the neck.

Recovery after a thyroidectomy

Patients should expect to stay in the hospital for at least one night after surgery. During your hospital stay, your care team will monitor your vitals. Your doctor will schedule a follow-up appointment approximately two weeks after your surgery to review the pathology results with you. If you need additional treatments based on the results, your doctor will discuss the next steps or treatment plan with you at this follow-up appointment.

Upon discharge, your care team will give you detailed discharge instructions that include:

Care for your incision

Your care team will teach you how to care for your incision at home. Your incisions will be removed one to two weeks after surgery. You should use sunscreen and cover the incision when you go outside. You can take a shower but don’t let the incision site get too wet.

Medications 

If you had your entire thyroid removed, you will likely need to take a thyroid medication for the rest of your life. Your doctor will work with you to ensure you are on the correct dosage to effectively manage your metabolism.

Pain management

You will be instructed on the most effective way to manage your pain. In some cases, an OTC medication may relieve your symptoms; in other cases, you may need a prescription pain reliever.

Activity level and return to work

Gradually return to your normal activity level and avoid any strenuous activity until your doctor has cleared you. Most patients can return to work within two weeks after surgery.