Thyroidectomy

What is it?

The thyroid is a butterfly-shaped gland located in the lower front part of the neck. Thyroid gland removal is a surgical procedure that involves taking out part or all of the thyroid. A nodule on the gland might be cancerous. An enlarged thyroid nodule or the entire gland can cause dangerous or troublesome symptoms, such as difficulty swallowing, breathing issues, or voice changes. A person with an overactive thyroid (hyperthyroidism) that doesn't respond to other treatments might be advised to undergo surgery. 

What is the aim of the procedure?

The main aim of the procedure is to remove the entire or a part of the thyroid gland.

What is done during the procedure?

During the procedure the thyroid gland is approached through an incision in the neck after which the thyroid gland is dissected and removed preserving the parathyroids(a gland involved in calcium mechanism) and Recurrent laryngeal nerve (Nerve that supplies the voice box). These may be combined with a neck dissection if neck nodes are found to be suspicious of cancer on either CT scan or FNAC.

The procedure will be carried out under general anesthesia. If you have any anesthetic concerns, please discuss with your anesthetist.

What are the risks associated with the procedure?

• Bleeding which could result in swelling about the wound exerting pressure on the windpipe causing breathing problems.

• Nerve supplying the vocal cords may be damaged which could result in temporary or sometimes permanent voice change. 

• Damage to the parathyroid gland may result in result in decreased calcium in blood which presents as tingling of fingers and spasms of the hands and toes. This is usually a temporary problem but occasionally long-term calcium supplements might be required.

• Removal of the entire thyroid gland results in a hypothyroid state which requires life-long thyroid supplements.

  
  

Post-operative care and follow-up:

Following the procedure, you will be having throat pain  and neck pain for which analgesics will be administered. You will be having drains in the neck following the procedure, which will be removed once the drain quantity reduces. Soakage of the wound can be expected if an open drain is placed. Gentle neck movements and regular oral feeds are encouraged. Suture removal will be removed on the 7th post-operative day. You will be discharged based on your general physical condition.

Based on the histopathological report, revision surgeries and radioiodine therapy might be needed. In case of thyroid malignancy life-long follow-up may be required. Supplement medications will be prescribed based on your physiological status.

a. I am scared of neck surgeries what should I do

If there is an issue with your thyroid we have diagnostic criteria based on ultrasound and FNAC. we have risk categorization based on which a surgery may be advised. yes, we get your concern. But when there is a trouble which needs surgical management, it needs to be addressed before it gets out of hand and become untreatable. Better safe than sorry

b. How long should i stay in hospital

Usually you will have to stay in hospital for 3 days by the time the drain will be removed and discharged with a simple dressing

c. How long will I have to take rest

Its best to avoid strain/stertorous activities for a week to 10 day

d. When will the sutures removed

Sutures will be removed after a week

e. What can I eat post procedure

Initially patients are started with Liquids followed by soft solid diets to solids. It is advisable to avoid cauliflower/brocolli post thyroidectomy or for hypothyroid patients in general since it can hinder in the hormone production. and it is advisable to use iodised salt.

f. can i take bath post procedure

Yes you are encouraged to take bath post procedure. Just make sure the surgical site doesnt come under direct contact with the water/soap