What is a thyroidectomy. Why might someone need this surgical procedure. What are the potential risks and complications associated with thyroid removal. How is the surgery performed and what can patients expect during recovery.

Understanding Thyroidectomy: Purpose and Types

Thyroidectomy is a surgical procedure that involves the removal of all or part of the thyroid gland, a butterfly-shaped organ located in the front of the neck. This gland plays a crucial role in regulating various bodily functions through the production of thyroid hormones.

There are two main types of thyroidectomy:

• Total thyroidectomy: Complete removal of the thyroid gland
• Partial thyroidectomy: Removal of a portion of the thyroid gland

The choice between these procedures depends on the underlying condition and the recommendation of the healthcare provider.

Indications for Thyroidectomy

Several conditions may necessitate a thyroidectomy:

• Thyroid cancer
• Thyroid nodules (benign or suspicious)
• Hyperthyroidism (overactive thyroid)
• Goiter (enlarged thyroid gland)
• Graves’ disease (an autoimmune disorder affecting the thyroid)

Can thyroidectomy be performed for non-cancerous conditions? Indeed, while thyroid cancer is a common reason for thyroidectomy, the procedure is also frequently performed for benign conditions that affect thyroid function or cause symptomatic enlargement of the gland.

Preoperative Evaluation and Preparation

Before undergoing a thyroidectomy, patients typically undergo a comprehensive evaluation to ensure they are suitable candidates for the procedure and to plan the surgery effectively.

Diagnostic Tests and Imaging

The preoperative workup often includes:

• Thyroid function blood tests
• Ultrasound of the thyroid gland
• Fine needle aspiration biopsy (if nodules are present)
• CT or MRI scans (in some cases)
• Laryngoscopy to examine vocal cord function

These tests help determine the extent of thyroid disease, guide surgical planning, and identify any potential complications.

Medication Adjustments

Patients may need to adjust their medications prior to surgery. Those with hyperthyroidism often require preoperative treatment to normalize thyroid hormone levels and reduce the risk of thyroid storm, a potentially life-threatening complication.

Are there any medications that should be avoided before thyroidectomy? Blood-thinning medications, including aspirin and certain herbal supplements, are typically discontinued several days before surgery to minimize bleeding risk. Patients should provide a complete list of their medications to their surgeon for specific instructions.

Surgical Techniques: Traditional vs. Minimally Invasive Approaches

Advancements in surgical techniques have expanded the options available for thyroidectomy, offering patients potential benefits in terms of cosmetic outcomes and recovery time.

Traditional Open Thyroidectomy

The conventional approach involves making a 4-6 cm incision in the front of the neck. The surgeon then carefully dissects the thyroid gland from surrounding structures, taking care to preserve important nerves and blood vessels.

Minimally Invasive Thyroidectomy

Several minimally invasive techniques have been developed, including:

• Minimally invasive video-assisted thyroidectomy (MIVAT)
• Robotic-assisted thyroidectomy
• Transoral endoscopic thyroidectomy vestibular approach (TOETVA)

These approaches typically result in smaller incisions or, in the case of TOETVA, no visible neck scar at all.

How does scarless thyroidectomy work? Transoral or scarless thyroidectomy involves accessing the thyroid gland through small incisions made inside the mouth. This technique eliminates visible neck scars but may not be suitable for all patients or thyroid conditions.

Potential Risks and Complications of Thyroidectomy

While thyroidectomy is generally considered a safe procedure, like all surgeries, it carries certain risks. Understanding these potential complications is crucial for informed decision-making and proper postoperative care.

Common Risks

• Temporary or permanent hoarseness due to recurrent laryngeal nerve injury
• Hypoparathyroidism leading to low calcium levels
• Bleeding or hematoma formation
• Infection at the surgical site
• Seroma (fluid accumulation)
• Scarring

Less Common but Serious Complications

• Airway obstruction
• Injury to the carotid artery or jugular vein
• Tracheal or esophageal injury
• Hypothyroidism (if total thyroidectomy is performed)

What is the most common complication after thyroidectomy? Temporary hypocalcemia due to transient hypoparathyroidism is the most frequent postoperative complication, occurring in up to 30% of patients. However, permanent hypoparathyroidism is much less common, affecting less than 3% of patients.

Postoperative Care and Recovery

The recovery process after thyroidectomy varies depending on the extent of surgery and individual factors. Most patients can expect to stay in the hospital for 1-2 days following the procedure.

Immediate Postoperative Period

In the hours following surgery, healthcare providers will closely monitor:

• Vital signs
• Incision site for bleeding or swelling
• Calcium levels
• Voice and swallowing function

Patients may experience some discomfort, which is typically managed with pain medication. A soft diet is usually introduced as soon as the patient can tolerate it.

Long-term Management

For patients who undergo total thyroidectomy, lifelong thyroid hormone replacement therapy is necessary. This involves taking daily medication to maintain normal thyroid hormone levels.

Regular follow-up appointments are crucial to adjust medication dosages and monitor for any late complications.

How long does it take to fully recover from thyroidectomy? Most patients can return to normal activities within 1-2 weeks after surgery. However, complete healing of the incision and resolution of all symptoms may take several weeks to months.

Thyroid Hormone Replacement Therapy

Following a total thyroidectomy, patients require thyroid hormone replacement to maintain normal bodily functions. This treatment is essential for regulating metabolism, energy levels, and overall health.

Types of Thyroid Hormone Replacement

• Levothyroxine (T4): The most commonly prescribed form
• Liothyronine (T3): Sometimes used in combination with T4
• Natural desiccated thyroid: Derived from animal sources, less commonly used

Monitoring and Dose Adjustments

Regular blood tests are necessary to ensure proper thyroid hormone levels. Dosage adjustments may be required based on test results and symptoms.

Is thyroid hormone replacement a lifelong commitment? For patients who have undergone a total thyroidectomy, thyroid hormone replacement is indeed a lifelong necessity. However, with proper management, most individuals can maintain normal thyroid function and lead healthy lives.

Long-term Outcomes and Quality of Life After Thyroidectomy

The long-term prognosis for patients who undergo thyroidectomy is generally favorable, especially when the procedure is performed by experienced surgeons at high-volume centers.

Factors Affecting Outcomes

• Underlying condition (benign vs. malignant)
• Extent of surgery (partial vs. total thyroidectomy)
• Presence of complications
• Adherence to thyroid hormone replacement therapy (if applicable)

Quality of Life Considerations

Many patients experience improved quality of life following thyroidectomy, particularly those who had symptomatic thyroid disease preoperatively. However, some individuals may face challenges related to:

• Adjusting to hormone replacement therapy
• Managing potential voice changes
• Coping with the psychological impact of surgery and lifelong medication

Can patients lead normal lives after thyroidectomy? With appropriate medical management and follow-up care, the vast majority of patients can lead full, active lives following thyroidectomy. Many report resolution of symptoms related to their thyroid condition and experience minimal long-term effects from the surgery itself.

Advances in Thyroid Surgery: Future Directions

The field of thyroid surgery continues to evolve, with ongoing research and technological advancements aimed at improving outcomes and patient experiences.

Emerging Technologies

• Intraoperative nerve monitoring to reduce the risk of vocal cord paralysis
• Energy-based surgical devices for more precise tissue dissection
• 3D printing for preoperative planning and surgical simulation
• Artificial intelligence applications in thyroid imaging and diagnosis

Personalized Medicine Approaches

Advances in molecular testing and genetic profiling are enabling more tailored treatment strategies for thyroid cancer patients, potentially reducing the need for extensive surgery in some cases.

How might thyroid surgery change in the coming years? Future developments may include further refinement of minimally invasive techniques, improved methods for preserving parathyroid function, and novel approaches to thyroid hormone replacement that more closely mimic natural thyroid function.

In conclusion, thyroidectomy remains a critical procedure in the management of various thyroid conditions. While it carries certain risks, ongoing advancements in surgical techniques and perioperative care continue to improve outcomes and patient experiences. As with any medical procedure, patients considering thyroidectomy should engage in thorough discussions with their healthcare providers to understand the potential benefits, risks, and long-term implications of the surgery.

Thyroidectomy | Johns Hopkins Medicine

Thyroidectomy is surgical removal of all or part of the thyroid gland, which is located in the front of the neck. The thyroid gland releases thyroid hormone, which controls many critical functions of the body.

What You Need to Know

• Thyroid cancer, thyroid nodules and other conditions may require thyroidectomy.
• Once the thyroid gland is removed, the person takes replacement thyroid hormone to keep the body’s functions in balance.
• Thyroidectomy can be performed through an incision at the front of the neck, or through the mouth (scarless thyroidectomy).

Why might I need a thyroidectomy?

A thyroidectomy may be appropriate for people who have a thyroid tumor, thyroid nodules or hyperthyroidism, which occurs when the thyroid gland produces too much thyroid hormone.

Hyperthyroidism can be the result of an autoimmune problem, too much iodine in the diet, a benign tumor in the pituitary gland, too much thyroid medication, a swelling (goiter) in the thyroid gland or an inflammatory process.

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)

What happens during a thyroidectomy?

Before the Procedure

The doctor will order imaging and laboratory tests, including:

• Thyroid imaging with ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI)

• Blood test(s) for thyroid hormone levels and other factors

• Examination of the vocal cords using an instrument called a laryngoscope

Just before your procedure, the surgical team may give you an antibiotic if you have a weakened immune system or other condition that makes you prone to getting infections. You may receive medicines to reduce nausea and vomiting (antiemetics).

For people with hyperthyroidism, the doctor will administer medications to keep thyroid hormones in balance during and after surgery.

Types of Thyroidectomy

Traditional Thyroidectomy

In the operating room, you will be in a semi-seated position, with or without your chin tilted back and with support under your neck and shoulders. Most thyroidectomies are performed under general anesthesia, meaning you are asleep and pain-free during the procedure.

The surgeon makes a small incision in the skin of the neck as close to a natural crease as possible to reduce the appearance of the scar. The surgeon parts a thin layer of muscle to gain access to the thyroid gland, then removes one or both lobes of the thyroid gland as well as any nearby lymph nodes that may be affected by disease.

The surgeon then returns the muscles of the front of the neck to their proper position and secures them in place. The skin is closed with sutures or glue.

Scarless (Transoral) Thyroidectomy

A newer technique involves accessing the thyroid gland through the mouth. This surgery leaves no visible scar since there is no incision on the outside of the neck.

Thyroidectomy: Recovery and Next Steps

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.

Thyroidectomy – Procedure & Risks

By Julie Lynn MarksMedically Reviewed by Robert Jasmer, MD

Reviewed: October 23, 2015

Medically Reviewed

Removal of the thyroid may be necessary due to cancer, enlargement, or noncancerous growths on the thyroid.

A thyroidectomy is surgery to remove part or all of a person’s thyroid.

The thyroid is a butterfly-shaped gland located at the base of your neck. It helps regulate your body’s metabolism.

A thyroidectomy might be needed if you have:

• Thyroid cancer
• Noncancerous growths on the thyroid
• An enlarged thyroid
• An overactive thyroid

A total thyroidectomy is a procedure to remove the entire thyroid.

A partial thyroidectomy means that just a portion of the gland is taken out.

The Thyroidectomy Procedure

A thyroidectomy can take up to four hours, depending on the type of surgery you’re having.

Most of the time, general anesthesia is given. This means you won’t be conscious during the procedure.

A surgeon will make an incision in the middle of your neck, or several small cuts in or near the neck.

If you’re having a conventional thyroidectomy, the surgeon will remove part or all of your thyroid through the incision in your neck.

If you’re having an endoscopic or robotic thyroidectomy, the surgeon will use small instruments and a video camera to perform the procedure through tiny incisions.

A catheter may be placed in the area to help drain blood and fluids.

Before a Thyroidectomy

Before your thyroidectomy, your doctor may perform tests to determine if a growth on your thyroid is cancerous.

You may also undergo imaging tests to find exactly where the thyroid growth is located.

Tell your doctor about all medicines you take before your surgery.

You might need to stop taking certain drugs, such as Plavix (clopidogrel bisulfate), aspirin, Advil (ibuprofen), Aleve (naproxen), or Coumadin (warfarin), prior to your procedure.

Let your doctor know if you smoke. Smoking may slow down your recovery.

Your doctor may prescribe a thyroid medicine or iodine treatment for you to take one to two weeks before your thyroidectomy.

You’ll probably be told not to eat or drink anything for several hours before your surgery. Follow your doctor’s instructions carefully.

After a Thyroidectomy

If you have a catheter in your neck to drain fluid, it’s usually removed the morning after your surgery.

You’ll probably be able to go home the day after your thyroidectomy, but you could spend up to three days in the hospital.

The length of your stay will depend on your medical condition and recovery. You must be able to swallow liquids and pills before you can return home.

It will take about three to four weeks for you to fully recover from your surgery.

If you’ve had your entire thyroid removed, you’ll probably need to take thyroid hormone pills for the rest of your life.

Risks of a Thyroidectomy

Potential risks of a thyroidectomy include:

• Bleeding or infection
• Difficulty breathing
• Permanent hoarseness or weak voice due to nerve damage
• Injury to parathyroid glands (glands near the thyroid) or their blood supply, which can cause low blood calcium levels and sometimes muscle spasms or other neuromuscular symptoms

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Editorial Sources and Fact-Checking

• Thyroid gland removal; MedlinePlus.
• Thyroidectomy; Mayo Clinic.
• Thyroidectomy; Cedars-Sinai.

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Thyroidectomy – removal of the thyroid gland

Prices Doctors Our centers

Indications Contraindications Preparation Surgery Rehabilitation Complications Thyroidectomy at SM-Clinic

Thyroidectomy is a surgical operation that involves complete or partial excision of the thyroid gland. Intervention is one of the main methods of treatment of malignant and benign neoplasms of this organ.

Indications

The most common indications for thyroidectomy are:

• thyroid cancer;
• large benign neoplasms: adenoma, nodes, cysts;
• multinodular goiter;
• diffuse toxic goiter;
• Thyroid nodes that produce hormones (toxic nodes).

Surgery is also indicated in cases where the patient develops cancer, but there are contraindications for radioiodine therapy.

Contraindications

Intervention is low-traumatic and therefore has a minimum number of contraindications. Thyroidectomy is not performed if the patient is found to have:

• acute infectious diseases;
• chronic pathologies in the acute stage;
• blood clotting disorders.

Preparation

As part of the preparation, you need to undergo a comprehensive examination, which includes:

• consultation with the attending physician;
• consultation with an anesthesiologist;
• blood tests, including coagulogram;
• urine tests;
• electrocardiogram.

If necessary, additional laboratory or instrumental studies, consultations with highly specialized specialists are prescribed.

Tell the doctor in advance about the medications the patient takes regularly. It is important to inform about the presence of allergies. As part of the preparation, a course of antibiotics may also be prescribed.

Promotion! Free consultation with a surgeon about surgery

Take advantage of this unique opportunity and get a free consultation about elective surgery.

Operation

Any type of thyroid surgery is performed under general anesthesia. The patient is put into a state of sleep and does not feel anything during the operation.

After the anesthesia has taken effect, the surgeon makes a transverse incision at the base of the neck. The incision is made in such a way that in the future the scar merges with the skin fold and is as inconspicuous as possible. After that, depending on the goals of the operation, the surgeon removes the pathology along with the thyroid gland or part of it. One of the main goals is to preserve the parathyroid glands and the recurrent nerve, if they are not affected by the disease.

After removing the tissues, the surgeon sews up the wound, puts a drain. Depending on the extent of the surgeon’s actions, the operation takes from 45 minutes to 3 hours.

Rehabilitation

After the intervention, you must stay in the hospital under the supervision of medical staff. Pain in the neck and throat persist for several days. Painkillers prescribed by a doctor help to get rid of pain.

The term of hospitalization is determined individually and depends on the volume of surgical intervention, the patient’s well-being. Often, after 2-3 days, discharge and continued recovery at home is possible.

If a total thyroidectomy, that is, the total removal of the thyroid gland, has taken place, a person will develop hypothyroidism after the operation. Therefore, there will be a need for a lifelong intake of hormonal drugs. However, even in the case of not total, but partial thyroidectomy, the thyroid gland may also lose its functions, which will have to be replenished with the help of drugs. Despite lifelong hormone replacement therapy, after recovery, a person will be able to lead a normal life without uncomfortable restrictions.

Complications

Complications after the intervention are quite rare. Among the most common: postoperative bleeding, hypoparathyroidism (lack of calcium in the body). If the laryngeal nerve is damaged during the operation, the timbre of the voice changes. Restoration of the usual timbre takes from 3 to 12 weeks. The risk of nerve damage is less than 1%.

Thyroidectomy at SM-Clinic

Surgical intervention on the thyroid gland refers to technically complex operations. The result of such treatment largely depends on the skills of the doctor. To minimize the risks and achieve the maximum positive effect, therapy should be trusted only by experienced surgeons who are proficient in advanced operating techniques. These are the doctors who work in the SM-Clinic.

We have been operating on patients since 2009. Our doctors perform more than 8500 operations annually in 20 surgical directions. Our team consists of over 140 experienced operating doctors and 18 anesthesiologists, including 20 doctors and candidates of medical sciences.

On the basis of our clinic in St. Petersburg, you can undergo a comprehensive preliminary examination. Our patients have at their disposal 7 operating theaters with modern equipment and 25 comfortable hospital wards.

Call us at the phone number listed on the website to find out the price of thyroidectomy, get acquainted with the price list for other services or sign up for a consultation.

* You can read more about the conditions here – Treatment on credit or installments

Preliminary cost. The exact cost of the operation can only be determined by the surgeon during a free consultation.

Specialists in this field 5 doctors

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Mikhailov Aleksey Gennadievich

Surgeon, oncologist, mammologist, endocrine surgeon

Work experience: 22 years

Udarnikov, 19

m. Ladozhskaya

Marshal Zakharov, 20

metro station Leninskiy pr-t

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m. Prosveshcheniya

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Boyko Alexander Aleksandrovich

Oncologist, oncodermatologist “SM-Clinic”

Work experience: 12 years

Danube, 47

Dunayskaya metro station

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901 56
Grinevich Vladimir Stanislavovich

Surgeon, oncologist, mammologist, coloproctologist

Work experience: 27 years

Vyborgskoe shosse, 17

metro Prosveshcheniya

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Pfanenshtil Anatoly Viktorovich

Surgeon, mammologist and oncologist. Doctor of the highest category.

Work experience: 15 years

Dunaysky, 47

Dunayskaya metro station

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment 9000 3
Khokhlov Sergey Viktorovich

Surgeon, oncologist, coloproctologist

Work experience: 28 y.o.

Our offices in St. Petersburg

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Thyroidectomy

The thyroid gland is an important endocrine organ that secretes hormones to regulate metabolic processes, electrolytes, the function of the nervous and reproductive systems. However, the thyroid gland is prone to disease. Among all diseases of the endocrine glands, thyroid pathologies are in second place in prevalence. Thyroid diseases are diagnosed, according to statistics from the World Health Organization, in every tenth person. At the same time, cases of thyroid disease increase every year, which is explained by unbalanced nutrition, depressing environmental conditions, the influence of hereditary factors, and the lack of an effective system for preventing iodine deficiency. Not all thyroid diseases are subject to effective conservative therapy. As a result, partial or radical removal of the thyroid gland becomes the main method for a number of indications.

A thyroidectomy is an operation to remove the thyroid gland. To overcome certain diseases, such as cancer, surgery involves the removal of lymph nodes in the trachea. Combined surgery makes cancer treatment effective and reduces the risk of recurrence.

DIAGNOSTIC EXAMINATION

Diagnosis before thyroidectomy includes the following measures:

– study of the level of hormones in the body;

– ultrasound examination of the gland and lymph nodes to detect pathologies;

– biopsy;

– laryngoscopy;

– CT scan;

– genetic research.

When is a thyroidectomy needed?

Thyroidectomy is recommended in situations where other treatments have failed or in malignant tumors. Patients with asymptomatic nodes are not recommended to carry out surgical intervention, since it is enough for them to limit themselves to dynamic observation. Thyroidectomy is performed in patients who have progressing pathology or suspected malignant transformations.

THE VOLUME OF THE PLANNED OPERATION DEPENDS ON THE NATURE OF THE PATHOLOGY AFFECTING THE THYROID GLAND

– Total thyroidectomy to remove the entire thyroid gland;

– Subtotal thyroidectomy, it is assumed that almost the entire gland is excised, leaving small areas and zones of the location of the parathyroid glands;

– Hemithyroidectomy to remove half of the organ with an isthmus with limited nodes of one of the lobes.

Thyroidectomy

The doctor makes an incision in the front of the neck, clamps and ties up the blood vessels. The thyroid gland – completely or partially – is cut off from other tissues. To prevent bleeding, special clamps are used that are responsible for the process of burying the ends of the vessels. The incision is sutured, the edges of the skin are fastened. It is often necessary to install drainage tubes to prevent fluid accumulation.