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

Vyborgskoe shosse, 17

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.