What are Thyroid surgeries?
It is a surgical operation that includes the total or partial surgical removal of the gland and the thyroid gland is an endocrine gland located in the neck and its main function is to secrete some hormones needed to regulate metabolism and regulate the body’s sensitivity to other hormones and produce proteins. It also works to regulate body temperature and energy consumption.
When would thyroid surgery be necessary?
We often resort to the surgery when the patient suffers from thyroid cancer or in cases of hyperthyroidism and treatment of thyroid tumors, and we resort to removing the thyroid gland if other drug treatments fail.
Also, the surgery is suitable for the following medical conditions such as: plastic surgery in the case of a very enlarged goiter, or obstructive symptoms that cause difficulties in swallowing or breathing.
Thyroidectomy might be followed by potential or consequent complications, lifelong need for thyroid hormone replacement, remote possibility of airway obstruction due to vocal cord paralysis, complications are uncommon when the operation is performed by an experienced surgeon.
There are some things that indicate the need to remove the thyroid gland, and they are as follows:
1) Goiter : It is a common problem and affects normal breathing and swallowing, and causes discomfort, pain, and swelling in the area under the chin and neck.
In this case, the removal of the thyroid gland can be complete or partial, and it does not pose a risk to the affected person, but its removal will help avoid the risks of these symptoms.
2) Hyperthyroidism : Hyperthyroidism is one of the most common problems and one of several things that indicate the need to remove the thyroid gland, as the gland secretes high levels of hormones, which leads to many health damages.
After the diagnosis, treatments may be reached, and we may resort to treating hyperthyroidism by taking medications, but in some cases a thyroidectomy is required, as medications cannot treat the problem and the complications it causes increase.
Also, hyperthyroidism medications can cause some health problems in the patient, which necessitates surgery.
3) Thyroid cancer : Usually, the doctor resorts to removing the entire thyroid gland when it has cancerous tumors, so that the tumors do not spread to the surrounding parts and cause serious health problems that threaten life.
In this case, the absence of the thyroid gland in the body is better than its survival, and the patient can live without it with the use of alternative medicines.
4) Thyroid nodules : They are solid masses filled with fluid. These nodules form inside the thyroid gland. They usually do not pose a threat to health, as most of them are not a cancerous tumor and can live with them.
But some cases of thyroid nodules require excision, when these nodules become large and affect the functions of the thyroid gland or cause health problems in the body.
Risks of the operation:
Thyroidectomy is associated with many risks, such as the following:
• Infection in the surgical incision.
• Bleeding.
• Hypersensitivity to anesthetics.
• Damage to the vocal cords, which causes a temporary or permanent change in the voice.
• Neurological injury.
• Damage to the parathyroid gland.
• Temporary or permanent low calcium.
• Bleeding.
• Hypersensitivity to anesthetics.
• Damage to the vocal cords, which causes a temporary or permanent change in the voice.
• Neurological injury.
• Damage to the parathyroid gland.
• Temporary or permanent low calcium.
What are the methods of thyroid surgery?
Thyroid surgery methods differ depending on the size of the tissue that must be removed, and this is done according to the diagnosis and includes types, such as:
Partial thyroidectomy: Partial removal of enlarged thyroid tissue.
Total thyroidectomy: The entire thyroid gland is removed.
Hemithyroidectomy: An entire thyroid lobe is removed.
Specific node excision: Nodes are removed from the thyroid gland.
Partial thyroidectomy: Partial removal of enlarged thyroid tissue.
Total thyroidectomy: The entire thyroid gland is removed.
Hemithyroidectomy: An entire thyroid lobe is removed.
Specific node excision: Nodes are removed from the thyroid gland.
There are important actions in the preoperative period:
Some tests are performed such as:
• Thyroid function test, complete blood count, blood chemistry, blood clotting functions, kidney and liver function tests.
• Performing other tests to obtain an accurate diagnosis, such as ultrasound imaging of the thyroid gland, and imaging tests using radioisotopes.
• A biopsy may be taken to check for any tumors.
• In the event that the patient is elderly, he is asked to perform a chest x-ray and electrocardiogram before the operation.
• The evaluation of medications that the patient must stop taking before surgery.
• Fasting for 8 hours before surgery.
• Thyroid function test, complete blood count, blood chemistry, blood clotting functions, kidney and liver function tests.
• Performing other tests to obtain an accurate diagnosis, such as ultrasound imaging of the thyroid gland, and imaging tests using radioisotopes.
• A biopsy may be taken to check for any tumors.
• In the event that the patient is elderly, he is asked to perform a chest x-ray and electrocardiogram before the operation.
• The evaluation of medications that the patient must stop taking before surgery.
• Fasting for 8 hours before surgery.
Necessary steps during surgery:
Thyroidectomy takes two hours, and is performed as follows:
• General anesthesia is done.
• The neck and chest area are well sterilized.
• A small incision is made in the front and lower part of the neck. After detecting the gland, the surgeon separates it from its place with the blood vessels that supply it with blood.
• The doctor removes the entire gland in cases of thyroid cancer, while only one part of it is removed in cases of hyperthyroidism.
• The incision is sutured, then a displaced tube is usually placed in the place of the incision to drain fluid remnants from the tissues.
• General anesthesia is done.
• The neck and chest area are well sterilized.
• A small incision is made in the front and lower part of the neck. After detecting the gland, the surgeon separates it from its place with the blood vessels that supply it with blood.
• The doctor removes the entire gland in cases of thyroid cancer, while only one part of it is removed in cases of hyperthyroidism.
• The incision is sutured, then a displaced tube is usually placed in the place of the incision to drain fluid remnants from the tissues.
There are some precautions necessary after the operation:
• The patient usually stays in the hospital about two or three days after surgery in any case; to make sure his condition is stable and he can eat and drink normally after one day.
• 4-6 weeks after the surgery, blood tests should be done to know the levels of thyroid hormones in the blood.
• After the results of the analyzes and according to them, the decision is made to give the patient replacement hormones.
• Taking the compensatory hormones for a patient who has had a thyroidectomy is a procedure that lasts for life, as his body is no longer able to permanently manufacture thyroid hormones.
• The surgical suture is removed at the appropriate time, and until then the surgical suture should remain covered permanently with medical tape, so the patient is advised not to shower or excessive washing until the surgical suture is removed.
• The “drainage” tubes are removed within a few days, usually the first and second after surgery, then the surgical stitches are taken out within ten days, and the “surgical stitches” are removed after a week of surgery – of course if self-absorbing sutures are not used. The patient is followed up after surgery to ensure the function of the vocal cords and nerves and to enslave any injury.
• The patient can continue all his previous activities only a week after his discharge from the hospital.
• May use analgesics as needed in case of pain.
• The patient may feel changes in the voice during the first days after surgery.
• The patient may be asked to receive complementary chemotherapy after thyroidectomy in cases of thyroid cancer, and this is determined based on the extent of the tumor’s spread. In addition, the patient receives complementary treatment that contains thyroid hormone.
• You should go to the doctor immediately if some symptoms appear, such as: severe pain, bleeding, shortness of breath, high temperature, and purulent secretions.
• 4-6 weeks after the surgery, blood tests should be done to know the levels of thyroid hormones in the blood.
• After the results of the analyzes and according to them, the decision is made to give the patient replacement hormones.
• Taking the compensatory hormones for a patient who has had a thyroidectomy is a procedure that lasts for life, as his body is no longer able to permanently manufacture thyroid hormones.
• The surgical suture is removed at the appropriate time, and until then the surgical suture should remain covered permanently with medical tape, so the patient is advised not to shower or excessive washing until the surgical suture is removed.
• The “drainage” tubes are removed within a few days, usually the first and second after surgery, then the surgical stitches are taken out within ten days, and the “surgical stitches” are removed after a week of surgery – of course if self-absorbing sutures are not used. The patient is followed up after surgery to ensure the function of the vocal cords and nerves and to enslave any injury.
• The patient can continue all his previous activities only a week after his discharge from the hospital.
• May use analgesics as needed in case of pain.
• The patient may feel changes in the voice during the first days after surgery.
• The patient may be asked to receive complementary chemotherapy after thyroidectomy in cases of thyroid cancer, and this is determined based on the extent of the tumor’s spread. In addition, the patient receives complementary treatment that contains thyroid hormone.
• You should go to the doctor immediately if some symptoms appear, such as: severe pain, bleeding, shortness of breath, high temperature, and purulent secretions.