Thyroidectomy for goiter: procedure, safety, side effects, and benefits

Definition

What is the thyroid gland?

The thyroid gland is a gland in the neck that produces the hormone thyroxine which plays a role in regulating the body's metabolism. These glands can become enlarged and this condition is known as a goiter.

What are the benefits of this operation?

The removal of the enlarged glands will restore the beauty of the neck. In addition, this surgery is useful for preventing or curing the respiratory system and difficulty swallowing.

Precautions & warnings

What should I know before having thyroidectomy surgery for goiter?

Most multinodular goitre euthyroids do not necessarily require surgery or medical therapy. Thyroid ultrasound periodically can monitor the condition of the patient's lump. Larger multinodular goiter requires an MRI or CT scan to assess thyroid size and rule out tracheal compression. The appropriate treatment for toxic multinodular goiter is by biopsy of the suspicious nodule or surgical excision, followed by radio-iodine therapy. Surgery is intended for simple goiter cases if:

there is clinical or radiological evidence of compression of the surrounding structures, especially the trachea

found a substernal goiter. Surgery must be performed because biopsy is difficult and clinical monitoring without a CT or MRI scan is unlikely to be successful

the goiter continues to grow

for aesthetic reasons - for example, the size of the lump is large or unsightly

Process

What should I do before having surgery?

In the preparation stage for surgery, make sure you tell your doctor about your health condition, any medications you are taking, or any allergies you have. The anesthetist will explain the anesthesia procedure and give further instructions. Make sure you follow all the doctor's instructions including the prohibition of eating and drinking before surgery. In general, you are required to fast for six hours before the surgery is performed. However, you may be allowed to consume drinks such as coffee a few hours before surgery. To anticipate possible postoperative laryngeal nerve damage, the patient's vocal cords should also be checked before thyroid surgery. Intraoperative nerve monitoring during thyroid surgery is highly recommended, especially for more complex surgeries such as re-operations and surgeries on large thyroid glands.

How is the thyroidectomy procedure for goiter?

This operation is performed under general anesthesia and usually takes 90 minutes to two hours. The surgeon will make an incision in the neck in one fold of skin, then remove part or all of the thyroid gland.

What should I do after having had a thyroidectomy for goiter?

After surgery, you will be allowed to go home after one to two days. The wound will probably heal after two weeks and you can return to work and activities. Regular exercise has also been shown to speed up the healing process. But before deciding to exercise, you should ask a doctor for advice. Usually, you will receive a scheduled visit to the next clinic. The surgeon will discuss any further medications or treatments you may need.

Complications

What complications can occur?

Complications that may occur after thyroid surgery include:

minor complications such as the presence of serous fluid (if the size is small and without any symptoms, it can heal on its own. However, if the size is large, a single / repeated aspiration may be required) and poor scar formation

bleeding, which can cause tracheal compression

Repetitive laryngeal nerve injury:

patients with unilateral vocal fold paralysis experience postoperative hoarseness

voice changes may not appear for days or weeks

unilateral paralysis resolves on its own

Bilateral vocal fold paralysis may occur following a total thyroidectomy procedure, and usually occurs shortly after extubation

the vocal cords remain in the paramedian position, causing partial airway obstruction

hypoparathyroidism: the resulting hypocalcemia may be permanent but is usually temporary. the cause of postoperative transient hypocalcemia is still unknown

thyrotoxic storm: is a rare postoperative complication but is potentially fatal

Superior laryngeal nerve injury:

the external branch provides motor functions to the cricothyroid muscle

trauma to the nerves results in the inability of the vocal cords to lengthen to produce high-pitched sounds

The external branch is the nerve most frequently injured in thyroid surgery

most patients do not notice changes in their vocal cords. however, his career as a professional singer may come to an end

infection: occurs in 1-2% of all cases. Perioperative antibiotics are not recommended for thyroid surgery

hypothyroidism

damage to the sympathetic trunk may occur but is rare.

You can reduce your risk of complications by following your doctor's directions before surgery, such as fasting and stopping certain medications.

Hello Health Group does not provide medical advice, diagnosis or treatment.