Thyroidectomy Overview

Thyroidectomy is the surgical removal of all or part of the thyroid gland. This gland is in the neck. It produces hormones that regulate metabolism. The surgery may be a:

• Total or near-total thyroidectomy—all of the thyroid is removed

• Thyroid lobectomy or partial thyroidectomy—removal of only a part of the thyroid (the right or left lobe and/or center)

The Thyroid Gland © 2009 Nucleus Medical Art, Inc.

Prior to Procedure

Your doctor may do the following:

• Physical exam
• Laboratory and/or imaging tests to assess thyroid function and anatomy, such as:

• Ultrasound —uses sound waves to evaluate organs in the body
• MRI —uses magnetic waves to produce images of the inside of the body
• Thyroid medicine to suppress thyroid activity in patients with hyperthyroidism
• Thyroid scan—uses a radioactive substance and scanning tool to evaluate the thyroid gland

Leading up to your procedure:

• Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
• Do not eat or drink anything after midnight the evening prior to the procedure.
• Arrange for transportation to and from the hospital.

Anesthesia

General anesthesia will be used. You will be asleep.

Description of Procedure

An incision will be made in the front of the neck. Bleeding vessels will be clamped and tied off. All or part of the thyroid gland will be cut away from other tissues in the neck. Care will be taken to avoid injury to other nearby glands and nerves. Bleeding is controlled with special tools that compress and seal the ends of the vessels. The incision will be closed. The edges of skin will be stitched together. A drain will often be left in overnight. It will help drain any extra fluids.

The thyroid may be removed to treat thyroid cancer. In this case, lymph nodes in the area may also be removed. This will test if the cancer has spread.

How Long Will It Take?

About 2-4 hours

How Much Will It Hurt?

Anesthesia prevents pain during the procedure. Pain after the procedure is common. You will be given medicine to help manage this.

Average Hospital Stay

The usual length of stay is one day. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care

At the Hospital

• There will be discomfort in your neck for several days. The pain can be treated with medicine.

• In some cases, you may have a hoarse voice for a few days.

• Depending on how much of the thyroid is removed, you may need to take replacement thyroid hormone.

• In some cases of thyroid cancer, you may need radioactive iodine treatments. This is called remnant ablation.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Keep the incision clean and dry.
• Do not get the incision wet until your doctor allows. If it does get wet, dry it immediately.
• Do not apply make-up, lotion, or cream to the incision area.
• Perform neck exercises as instructed by your doctor.
• Take all medicines as prescribed by your doctor.
• Be sure to follow your doctor's instructions .

RESOURCES:

The American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS)
http://www.entnet.org/

National Cancer Institute
http://www.cancer.gov/

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca/

Canadian Society of Otolaryngology
http://www.entcanada.org/

References:

Meeker MH, Rocthrock JC. Alexander's Care of the Patient During Surgery. 11th ed. Philadelphia, PA: Mosby; 1999.

American Association of Clinical Endocrinologists website. Available at: http://www.aace.com/ .

Sabiston DC Jr. Textbook of Surgery. 17th ed. Philadelphia, PA: WB Saunders Co.; 2004.