Thyroid Surgery

It is a surgical procedure in which a part of or the entire thyroid gland is removed. The thyroid gland is located centrally in the front of the neck and if healthy, is not visible. An inflamed thyroid tends to swell and become more prominent on the neck.

Why might you need a Thyroidectomy?

• Thyroid cancer
• Non-cancerous enlargement of the thyroid gland
• Suspicion of cancer, e.g. thyroid tumour on FNAC (Fine Needle Aspiration Cytology) and thyroid nodule with risk factors.
• If thyroid swelling is very large it causes pressure on the trachea or oesophagus causing difficulty breathing or swallowing.
• Cosmetic. A large nodule or a multinodular goitre.

Types of thyroid surgery

• Hemithyroidectomy- The complete removal of one lobe and the isthmus.
• Subtotal thyroidectomy- Removal of more than one half of the thyroid lobe on each side and the isthmus.
• Near-total thyroidectomy- Removal of the complete thyroid lobe on one side along with the isthmus leaving only a small part of the other side.
• Total thyroidectomy- Complete removal of the thyroid gland.
• Isthmusectomy- Complete removal of the isthmus.
• Completion thyroidectomy- Removal of the remaining thyroid gland to make it into a complete or subtotal thyroidectomy.

Risks

Generally, thyroidectomy is a safe procedure but like any surgery, it also carries a risk of complications like bleeding, infection, voice change, airway blockage. However, these risks are mitigated by the doctors who ensure that complications are prevented/ minimised during the procedure.

Post-Operative Management

After thyroidectomy, few patients may experience neck pain which can be treated with painkillers. Some patients may need to have a drain placed under the wound to prevent the collection of blood. This drain is usually removed 3-5 days after the surgery. Patients will be able to eat and drink as usual after the surgery. They may be able to go home on the next day and resume regular activities. Patients, however, are specially instructed to avoid vigorous activities such as heavy lifting or any strenuous activity. It takes up to 10-15 days for the wound from the surgery to heal. In cases of total thyroidectomy (complete removal of the thyroid gland), the patient would also be asked to take hormones in the form of tablets for the rest of their life.