Endocrine Surgery

Thyroidectomy

A thyroidectomy may be recommended for conditions such as:

  • Thyroid cancer
  • An indeterminant thyroid nodule
  • Goiter, a noncancerous enlargement of the thyroid
  • Certain cases of hyperthyroidism (Graves Disease)

 There are three main types of thyroid surgery:

  • Total Thyroidectomy -- Complete Removal of the Thyroid
    This is the most common type of thyroid surgery, and is often used for thyroid cancer. It is also used for goiter and Graves'/hyperthyroidism treatment.
  • Thyroid Lobectomy -- Removal of Half of the Thyroid Gland
    For this operation, cancer must be small and non-aggressive -- follicular or papillary -- and contained on one side of the gland.
  • Subtotal/Partial Thyroidectomy -- Removal of part of a Lobe
    Rarely used to biopsy a nodule.   If there are cancerous cells, a completion thyroidectomy will often be performed.  

what preparation is required?

  • Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition.
  • After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
  • Blood transfusion and/or blood products may rarely be needed depending on your condition.
  • It is recommended that you shower the night before or morning of the operation.
  • After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery.
  • Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and large doses of Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
  • Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
  • Quit smoking and arrange for any help you may need at home.

how is a thyroidectomy performed?

You will most likely be asked to check into the hospital the morning of your surgery.

  • A thyroidectomy is performed under a general anesthesia, so that the patient is asleep during the procedure, which usually takes one to two hours.
  • During the surgery, a nerve monitor is typically used to help identify and protect the recurrent laryngeal nerves.  
  • A small incision is made in the front of the neck, and all or part of the thyroid gland is removed, depending on the reason for the surgery.
  • After the surgeon removes the intended part of the thyroid gland, the small incision is closed.

what should i expect after surgery?

Our goal is for your surgery and recovery to be as comfortable and convenient as possible.  After a thyroidectomy, you may experience temporary neck pain and a hoarse or weak voice. A  sore throat and some difficulty swallowing may last for 3-7 days. The long-term effects of a thyroidectomy depend on how much of the thyroid is removed. If only part of your thyroid is removed, the remaining part typically takes over the function of the entire thyroid gland, and most patients don't need thyroid hormone therapy.

If your whole thyroid is removed (total thyroidectomy), your body can't make thyroid hormone and you will develop signs and symptoms of hypothyroidism.  As a result, you will need daily treatment with thyroid hormone. This hormone is identical to that normally made by your thyroid gland and performs all of the same functions. The amount of thyroid hormone replacement you need is determined by blood tests.

  • Most Patients are able to engage in light activity while at home after surgery. Patients can shower over their steristrips and tegaderm dressing the day after the operation.
  • Post-operative pain is generally mild and patients may require a pain pill or pain medication.
  • Most patients can resume normal activities within one week, including driving, walking up stairs, light lifting, and work.
  • You should call and schedule a follow-up appointment within 2 weeks after your operation.

what complications can occur?

Thyroid surgery is generally considered extremely safe. As with any operation, there is a risk of a complication. Complications during the operation may include:

  • Hoarse or weak voice which in rare cases may be permanent
  • Hypoparathyroidism causing low levels of calcium in your blood (hypocalcemia)
  • Bleeding and airway obstruction
  • Rarely infection of the wound
  • Adverse reaction to general anesthesia

when to call your doctor

Be sure to call your physician or surgeon if you develop any of the following symptoms after surgery:

  • Numbness or tingling of toes, fingers or around the mouth
  • Persistent fever over 101 degrees F (39 C)
  • Chills
  • Bleeding
  • Pain that is not relieved by your medications
  • Persistent nausea or vomiting
  • You are unable to eat or drink liquids
  • Persistent cough or shortness of breath
  • Purulent drainage (pus) from the incision
  • Redness surrounding the incision that is worsening or getting bigger

if you go to the emergency room

  • Go to the University of Tennessee Emergency Room if practical
  • Call University Surgeons Associates, PC (865) 305-9621 before you go
  • Your surgeon or the surgeon on call can make advance arrangements for you; this will expedite your evaluation and treatment
  • When you arrive, tell the triage nurse you are our patient and were instructed to have us called when you got to the ER

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