If you have been diagnosed with thyroid nodules or thyroid cancer, you may be offered surgery. There are different types of surgery available depending on whether you have nodules or cancer, the type of cancer and the stage it is at.
These are:
Partial Thyroid Lobectomy
This is where a small portion of the thyroid gland is removed. It is usually only done to remove benign lumps.
Thyroid Lobectomy
This procedure is done if you have non-cancerous nodules. The half of the thyroid gland that contains the nodules will be removed. Although this is done with a general anaesthetic, it is a fairly simple operation and you may be allowed to go home the same day.
Thyroid Lobectomy with Isthmusectomy
This operation is similar to the thyroid lobectomy except that the isthmus (the connection between the lobes) is also removed. It is sometimes done instead of a thyroid lobectomy to make sure that enough tissue has been removed to resolve the health concern. It is a technique that can be used for small cancers that aren’t aggressive.
Subtotal Thyroidectomy
This is when three-quarters of the thyroid gland is removed, all of the affected lobe, the isthmus and most of the opposite lobe. This is done if you have a small cancer or goiter that is causing neck problems.
Total Thyroidectomy
This is when the entire thyroid gland is removed. This is done for more aggressive, larger tumors. Many surgeons, however, opt for this type of surgery no matter what your stage of cancer, to stop the cancer spreading.
How is the Surgery Carried Out?
The surgeon will make an incision in the lower central neck, 3-5 inches long and remove part or all of the thyroid gland through that. Then the incision will be sewn up.
Small, partial removals may be done as a day case. For larger operations, you should expect to stay in hospital for two days.
Complications of Thyroid Surgery
These include nausea, vomiting, sore throat, headache, urinary retention, cut lips and chipped teeth (caused by insertion of the breathing tube), pneumonia, blood clots, stroke, heart attack, infection, excessive bleeding that may require a blood transfusion, allergy to anaesthetic, neck injuries and damage to the recurrent laryngeal nerves.
The laryngeal nerves are responsible for the movement of the vocal cords and if they are damaged it may make you temporarily hoarse, or in some cases the hoarseness is permanent. This side effect occurs in 1-2 percent of people having thyroid surgery.
Another risk is injury to the parathyroid glands, leading to low blood calcium levels. If this happens you will need to take calcium supplements for the rest of your life. Your scar might also feel uncomfortable (beyond the normal recovery time) or look unsightly.
Recovery
After you go home, you should avoid getting your scar wet and not do any excessive exercise or heavy lifting for up to 10 days afterwards. During this time, after about a week, you will have your stitches removed.You may need to take hormone replacement tablets if you have had all of your thyroid gland removed.
If you have a sore throat that continues for more than three weeks, or you notice swelling or have a fever, tell your doctor in case you have an infection. You should be able to get back to your usual activities within a few weeks.
Sources:
Thyroid Operations, Endocrine Web. Web. 20 January 2012. http://www.endocrineweb.com/conditions/thyroid/thyroid-operations
Thyroid Lobectomy, Penn Medicine. Web. 20 January 2012. http://www.uphs.upenn.edu/surgery/clin/eos/ThyroidLobectomy.html
Thyroid Surgery, Plain Patient Education. Web. 20 January 2012. http://www.nlm.nih.gov/medlineplus/tutorials/thyroidsurgery/gs119105.pdf
Complications of Thyroid Surgery. Author: Pramod K Sharma. Medscape Reference. Web. 20 January 2012. http://emedicine.medscape.com/article/852184-overview
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting.
Reviewed January 20, 2012
by Michele Blacksberg RN
Edited by Jody Smith