Thyroid gland surgery

The most common reasons which necessitate surgery are nodular enlargement (goiter) which causes symptoms (swallowing, breathing, and local pressure symptoms, globus sensation), hyperactive thyroid gland, and a malignant tumor or its suspicion.

By removing an enlarged, potentially pathologically hyperactive, or a tumorous thyroid gland, the symptoms of a local space occupying process and/or hormonal hyperactivity can be abolished, and the spread of the tumor can be abolished or hindered. The extent of the intervention (one lobe or both lobes, complete or almost complete removal) can be planned in advance in most of the cases, but rarely it can occur that it is decided during surgery, when the opportunity is given to accurately evaluate the thyroid gland’s condition.

Non surgical options for the treatment of thyroid gland diseases:

Benign neoplasms, certain inflammatory thyroid gland diseases, and degenerative thyroid nodules may be treated with radioactive iodine isotope treatment, or radiofrequency ablation (thermal treatment by gland puncture) too. The effectiveness of these comes close, but in most cases, it does not reach the effectiveness of surgical treatment, and they might not provide a permanent solution. These are mostly recommended when the risk of the surgery is too high due to a poor general health condition, or when the patient does not want to get surgery. The treating endocrinologist provides the recommendation for an isotope treatment and its detailed information.

What happens to you in the operating room?

The surgery must be performed in general anesthesia. The intervention is performed through a slightly curved incision made on the neck. One (lobectomy) or both lobes of the thyroid gland are removed during the surgery. Occasionally, it is allowed that a small part of the thyroid gland is left (near total, or subtotal removal). Rarely, it is sufficient that only a tiny area of the thyroid gland is removed (enucleation).

It can be necessary to remove the cervical lymph nodes too in those cases where the procedure is performed due to a malignant process. One or two fine tubes (drains) made of silicone are inserted during most surgeries, but not necessarily.

What happens to you right after the surgery?

You may talk and move your head and neck freely after the surgery. If you have drains, please take care of them, and do not tug on them! You can swallow after the surgery, but primarily, please only consume fluids on the day of the surgery. Water may touch the wound after 3 days. Male patients should protect the wound area for a week during shaving.

Usually, the drain is removed on the first or second day after the surgery, depending on the drained amount. The surgical stitches or staples, if they are not absorbable, are usually removed on the 2nd day after the surgery; it is possible to deviate from this according to the surgeon’s instructions, who performed the surgery. A follow up examination is recommended on the 7th -10th days unless your treating physician orders otherwise.

What happens if the justified surgical treatment is not performed?

A benign process will grow, the symptoms will increase, and a malignant neoplasm will develop.
In case of a malignant process, the deterioration of the general condition can be expected if the intervention is not performed.