Surgery may be also recommended for nodules with benign biopsy results if the nodule is large, if it continues to increase in size or if it is causing symptoms discomfort, difficulty swallowing, etc. Surgery is definitely indicated to remove nodules suspicious for thyroid cancer. In the absence of a possibility of thyroid cancer, there may be nonsurgical options for therapy depending on your diagnosis.
You should discuss other options for treatment with your physician who has expertise in thyroid diseases. As for other operations, all patients considering thyroid surgery should be evaluated preoperatively with a thorough and detailed medical history and physical exam including cardiopulmonary heart and lungs evaluation. An electrocardiogram and a chest x-ray prior to surgery are often recommended for patients who are over 45 years of age or who are symptomatic from heart disease.
Blood tests may be performed to determine if a bleeding disorder is present. Importantly, any patient who has had a change in voice or who has had a previous neck operation thyroid surgery, parathyroid surgery, spine surgery, carotid artery surgery, etc.
This is necessary to determine whether the recurrent laryngeal nerves that control the vocal cord muscles are functioning normally. Finally, in rare cases, if medullary thyroid cancer is suspected, patients should be evaluated for endocrine tumors that occur as part of familial syndromes including adrenal tumors pheochromocytomas and enlarged parathyroid glands that produce excess parathyroid hormone hyperparathyroidism.
In general, thyroid surgery is best performed by a surgeon who has received special training and who performs thyroid surgery on a regular basis. The complication rate of thyroid operations is lower when the operation is done by a surgeon who does a large number of thyroid operations each year. Patients should ask their referring physician where he or she would go to have a thyroid operation or where he or she would send a family member.
In experienced hands, thyroid surgery is generally very safe. Complications are uncommon, but the most serious possible risks of thyroid surgery include:. These complications occur more frequently in patients with invasive tumors or extensive lymph node involvement, in patients undergoing a second thyroid surgery, and in patients with large goiters that go below the collarbone into the top of the chest substernal goiter.
Prior to surgery, patients should understand the reasons for the operation, the alternative methods of treatment, and the potential risks and benefits of the operation informed consent. Your surgeon should explain the planned thyroid operation, such as lobectomy hemi or total thyroidectomy, and the reasons why such a procedure is recommended. For patients with papillary or follicular thyroid cancer, many, but not all, surgeons recommend total or neartotal thyroidectomy when they believe that subsequent treatment with radioactive iodine might be necessary.
A hemithyroidectomy may be recommended for overactive solitary nodules or for benign onesided nodules that are causing local symptoms such as compression, hoarseness, shortness of breath or difficulty swallowing.
The answer to this depends on how much of the thyroid gland is removed. If you have your entire gland removed total thyroidectomy or if you have had prior thyroid surgery and now are facing removal of the remaining thyroid completion thyroidectomy then you have no internal source of thyroid hormone remaining and you will definitely need lifelong thyroid hormone replacement.
Once you have met with the surgeon and decided to proceed with surgery, you will be scheduled for your pre-operative evaluation see above You should have nothing to eat or drink after midnight on the day before surgery and should leave valuables and jewelry at home. Total thyroidectomy involves the removal of the entire thyroid gland. This procedure is most often performed to treat thyroid cancer, but it may also be performed to treat uncontrollable hyperthyroidism or goiter that causes severe symptoms.
If you're having thyroidectomy as a result of thyroid cancer, we may remove lymph nodes around your thyroid to be examined by a pathologist. We use the smallest incisions possible, to limit scarring to your neck and deliver the best possible cosmetic results. General anesthesia is used during a thyroidectomy, and you'll usually stay in the hospital for one night following the procedure.
After your procedure, you will need to take thyroid hormone for the rest of your life, because your thyroid gland will no longer supply you with the necessary hormone. Your primary care provider or endocrinologist will do blood tests to ensure that you are getting the right amount of thyroid hormone.
You might also have to take supplements after thyroidectomy to balance your calcium levels. In the weeks after your thyroidectomy, you may have neck pain, soreness of your vocal chords or a weak voice.
These symptoms are usually temporary. A thyroid lobectomy is used to remove one of your two thyroid lobes, leaving the other intact.
We may perform this type of surgery if there are nodules that cause symptoms or could be cancerous. We also use it to treat excessive hormone production like that associated with hyperthyroidism. This surgery leaves no visible scar since there is no incision on the outside of the neck. In some cases, patients return home the same day as the surgery, but some people spend the night in the hospital.
There, the team can observe the patient and monitor calcium levels in the blood. When the thyroid gland is surgically removed, the body still requires thyroid hormone to keep vital functions in balance. Thyroid hormone replacement therapy involves taking synthetic or naturally derived thyroid hormones in pill form.
Health Home Treatments, Tests and Therapies. What You Need to Know Thyroid cancer, thyroid nodules and other conditions may require thyroidectomy. Why might I need a thyroidectomy? What are the risks of thyroidectomy? Voice changes, such as hoarseness Sore throat Bleeding and blood clots Adhesions or scar tissue that require another surgery Injury to the esophagus or trachea windpipe Hypoparathyroidism too little parathyroid hormone, which can result in abnormally low blood calcium levels.
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