It is a surgical procedure in which part or the entire thyroid gland is excised. The thyroid gland is located centrally in the front of the neck and when healthy, is not visible. An inflamed thyroid tends to swell and become more prominent on the neck.
Why might you need a Thyroidectomy?
- Thyroid cancer
- Non-cancerous enlargement of the thyroid gland
- Suspicion of cancer, e.g. thyroid tumour on FNAC (Fine Needle Aspiration Cytology) and thyroid nodule with risk factors.
- If thyroid swelling is very large, it causes pressure on the trachea or oesophagus, causing difficulty breathing or swallowing.
- Cosmetic. A large nodule or a multinodular goitre.
Types of thyroid surgery
- Hemithyroidectomy- It is the complete removal of one lobe and the isthmus.
- Subtotal thyroidectomy- This is where more than half of the thyroid lobe on each side is removed, along with the isthmus.
- Near-total thyroidectomy- It is the removal of the complete thyroid lobe on one side along with the isthmus leaving only a small part of the other side.
- Total thyroidectomy- This is where the entire thyroid gland is removed.
- Isthmusectomy- It is the complete removal of the isthmus.
- Completion thyroidectomy- It is the removal of the remaining thyroid gland, making it a complete or subtotal thyroidectomy.
Risks
Generally, thyroidectomy is a safe procedure, but like any surgery, it also carries a risk of complications like bleeding, infection, voice change, and airway blockage. However, these risks are minimised by doctors, ensuring that complications are prevented/ minimised during the procedure.
Post-Operative Management
After thyroidectomy, few patients may experience neck pain that can be treated with painkillers. Some patients may need a drain placed under the wound to prevent blood collection. This drain is usually removed 3-5 days after the surgery.
Patients will be able to eat and drink as usual after the surgery. They may go home the next day and resume regular activities. Patients, however, are specially instructed to avoid vigorous activities such as heavy lifting or any strenuous activity. It takes up to 10-15 days for the wound from the surgery to heal.
In cases of total thyroidectomy (complete removal of the thyroid gland), the patient would be prescribed hormones in the form of tablets for the rest of their life.