Surgery (Thyroidectomy)

When is surgery performed?

Surgery (thyroidectomy) is the primary treatment for suspected thyroid cancer and can be used to treat hyperthyroidism. Surgery is used to remove large goiters that make breathing or swallowing difficult. Occasionally, a goiter may be removed for cosmetic reasons.Can you tell me more about cancer surgery?

If thyroid cancer is suspected, your doctor will recommend surgery. The surgeon usually removes only one lobe of the thyroid, unless cancer is confirmed at surgery. A section of the gland is tested during surgery (frozen section) to tell the surgeon whether it is cancerous (malignant) or not cancerous (benign). If it is malignant, all or most of the thyroid is removed. If the cancer has spread outside of the thyroid, lymph nodes in the neck may also have to be removed. In addition, radioactive iodine therapy may be needed six weeks after surgery to destroy any remaining cancer tissue.

How is the cancer surgery operation done?

The operation is usually performed under general anesthesia and takes about two hours. After surgery, patients may stay in the hospital for up to three days. They may also need to take some time off from work (a week or two for a desk job and three to four weeks for physical labor).

Are there any risks to thyroid surgery?

Thyroid surgery is a safe treatment. However, as with any surgery, there are risks. About 1% of patients develop problems with normal speech caused by damage to nerves leading to the voice box, which lies very close to the thyroid. Occasionally, there may be damage to the parathyroid glands, which control the level of calcium in the blood. If this happens, the patient will need to take calcium and other medicines to prevent future problems. Minor risks of surgery include infection, bleeding, and a scar. The chance of death is very small.

What can be expected with thyroid surgery?

  • Patients will be in the hospital for one to three days.
  • Surgery is usually done under general anesthesia and lasts about two hours.
  • A small cut approximately three to four inches long is made along the natural crease of the neck.
  • After going to the recovery room for a few hours, patients are returned to their rooms. Patients can usually get out of bed, eat, and have visitors the evening of the surgery.
  • It can take up to a year for the scar to heal and the redness to disappear.
  • Because most of the thyroid gland is removed, some patients will have to begin lifelong thyroid hormone replacement.

What are the possible complications of thyroid surgery?

  • The four parathyroid glands located around the thyroid gland can be accidentally damaged causing low calcium levels that can lead to muscle spasms, convulsions, and the formation of cataracts, if untreated.
  • Minor voice changes are not uncommon, but only 1% of those operated on have major voice problems. The nerves from the larynx (voice box) are very near the thyroid gland and sometimes pass through the gland. It is sometimes unavoidable that they are damaged during surgery.
  • As with any surgery, there is the risk of surgical death, bleeding, and infection.