Thyroid Surgery: What to Expect?

Thyroid surgery is the primary treatment for thyroid cancer, thyroid nodules and hyperthyroidism.  During the procedure, all or part of the butterfly-shaped thyroid gland located at the front of the throat is carefully removed.  Here, we'll take a closer look at what the procedure involves, plus we will discuss ways your body may change after thyroid surgery.

About Thyroid Surgery

Surgery is normally used to treat thyroid problems in a number of cases.  For instance, if your doctor has diagnosed you with thyroid cancer or if it is suspected that thyroid cancer is developing, you are a likely candidate for thyroid surgery.  In addition, if you have a benign thyroid nodule that has begun to interfere with swallowing or breathing, or if you have a fluid filled thyroid nodule which returns after having been drained more than once, you are a candidate for surgery.  Thyroid surgery is also prescribed for hyperthyroidism and Graves Disease which does not respond to radioactive iodine or medications.

During thyroid surgery, you may have your entire thyroid gland removed, or you may need to have only a portion of your thyroid removed.  If you require a total thyroidectomy, the entire gland, along with the lymph nodes surrounding it will be removed. 

If you require a thyroid lobectomy, either with or without an isthmectomy, only the affected lobe will be removed.  With an isthmectomy, the isthmus, which is the band of tissue that connects the two lobes, will be removed as well.  Before finishing surgery, the surgeon will have the removed tissue analyzed to determine whether cancer is present.  If cancer is present within the cells, the surgeon will remove the remainder of the thyroid.  This is called a completion thyroidectomy.

In cases of hyperthyroidism caused by Graves Disease, a subtotal thyroidectomy will be performed.  In this thyroid surgery, one complete lobe, part of the second lobe, and the isthmus will be removed.

Thyroid surgery once required long incisions which completely opened the neck; today, many surgeons are conducting endoscopic thyroidectomies using a number of small incisions which allow surgical instruments and a tiny camera to be inserted into the surgical site.  Not only does this reduce the appearance of scars post-surgery, it also reduces recovery time and produces less pain than standard thyroidectomies do.

As with most modern surgeries, thyroid surgery is generally safe.  There are some complications which may occur due to the surgery, including a changed voice or persistent hoarseness brought on by nerve damage.  The best way to avoid this is to select an experienced surgeon; in addition, those having lobectomies rather than complete thyroidectomies are at lower risk for speech difficulties.

If the parathyroid glands are damaged or mistakenly removed during a total thyroidectomy, then hypoparathyroidism can result.  This is not a common problem encountered in patients having lobectomies, and again, the more experience a surgeon has, the less risk there is of accidental parathyroid gland removal.

Thyroid surgery patients are sometimes seen on an outpatient basis; most remain in the hospital for a day or two after surgery.

Additional Considerations

If you must undergo a total thyroidectomy, you will need to take synthetic thyroid hormone; this can also occur if you have a subtotal thyroidectomy or a lobectomy.

If you have been diagnosed with thyroid cancer and have undergone thyroid surgery, you will more than likely require treatment with radioactive iodine after the surgery, to ensure that all the cancer cells and thyroid tissue are gone. 

If you have undergone thyroid surgery for hyperthyroidism, you may have low calcium levels; in this case, you will need to take calcium supplements. Be sure to have a discussion with your doctor regarding any concerns you may have surrounding thyroid surgery.  While the risk for complications is present, most patients go on to enjoy life better than they have in many years, once thyroid surgery is successfully completed.