In Content, Surgery

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Thyroid Surgery

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The thyroid gland plays a crucial role in regulating various bodily functions, including metabolism, energy levels, and hormone production. However, thyroid glands are vulnerable to some complications that require treatment by surgery. This article will guide you about thyroid surgery and how you dealt with them.

What can be wrong with the thyroid?

The thyroid gland is an endocrine gland located in the front of the neck, just below the Adam’s apple. The thyroid gland is divided into two lobes, the right and left, each about the size of a plum cut in half. These two lobes are located on either side of your windpipe and are connected by the isthmus, a small bridge of thyroid tissue. 

Thyroid Surgery

Thyroid glands make two hormones: Thyroxine (T4), and Triiodothyronine (T3). Both of them consist of iodines and are for the regulation of metabolism inside your body cells and tissue. 

Meanwhile, the thyroid gland may experience some abnormalities, such as:

  • Thyroid nodules: These are abnormal growths that can form inside the thyroid gland. While the majority of nodules are harmless, some can be cancerous or cause symptoms such as difficulty swallowing or breathing.
  • Hyperthyroidism: Hyperthyroidism occurs when the thyroid gland produces an abnormally large amount of thyroid hormones. It can lead to symptoms such as weight loss, rapid heartbeat, anxiety, and fatigue.
  • Hypothyroidism: Unlike hyperthyroidism, hypothyroidism is caused by a thyroid gland that is underactive and does not produce enough thyroid hormones. Fatigue, weight gain, depression, and cold intolerance are all possible side effects.
  • Thyroid cancer: Thyroid cancer, while uncommon, can develop within the thyroid gland. Surgery is frequently recommended as part of a thyroid cancer treatment plan.

Are there other means of treatment?

While thyroid surgery may be necessary in certain cases, other treatment options exist depending on the specific thyroid condition. For instance:

  • Medications: In cases of hyperthyroidism, medications such as beta-blockers, or antithyroid drugs may be prescribed to manage symptoms and reduce hormone production.
  • Radioactive iodine therapy: This treatment option involves the administration of radioactive iodine, which destroys thyroid cells and reduces hormone production in cases of hyperthyroidism or thyroid cancer.
  • Hormone replacement therapy: For individuals with hypothyroidism, synthetic thyroid hormone medications can be prescribed to replace the hormones that the thyroid gland is not producing adequately.
  • Watchful waiting: In some cases, particularly for small benign nodules, a watchful waiting approach may be adopted. Regular monitoring and periodic ultrasound examinations are conducted to assess the growth and development of the nodules.

However, there are some conditions that only recommend treatment are surgery including

  • Thyroid cancer
  • Nodules that can be developed into thyroid cancer (follicular neoplasm or atypical findings)
  • Nodules or goiters that lead to compression of the trachea, difficulty swallowing, or visible or unsightly mass
  • Nodules or goiters that suffer from toxic nodules, toxic multinodular goiters, or Graves’ disease 

Physicians will determine your condition of thyroid abnormalities through physical examination, a blood test to assess thyroid hormone levels, an imaging test using ultrasound or scanners, and a fine-needle aspiration biopsy to determine the conditions of thyroid cells.

What needs to be done to receive thyroid surgery?

As with other operations, all patients contemplating thyroid surgery should be evaluated preoperatively with a thorough and detailed medical history and physical exam, which includes a cardiopulmonary (heart and lungs) evaluation. An electrocardiogram and a chest x-ray are frequently recommended prior to surgery for patients over the age of 45 or who are experiencing symptoms of heart disease. Blood tests may be performed to determine the presence of a bleeding disorder.

Importantly, any patient with a change in voice, a previous neck operation such as thyroid surgery, parathyroid surgery, spine surgery, or carotid artery surgery, and/or a suspected invasive thyroid cancer should have their vocal cord function evaluated routinely before surgery. This is required to see if the recurrent laryngeal nerves, which control the vocal cord muscles, are functioning normally.

Finally, if medullary thyroid cancer is suspected, patients should be evaluated for endocrine tumors such as adrenal tumors or pheochromocytomas, as well as enlarged parathyroid glands that produce excess parathyroid hormone, or hyperparathyroidism.

If your conditions meet the criteria and you are appointed to have surgery You should have nothing to eat or drink after midnight on the day before surgery and should leave valuables and jewelry at home.

What is being done during the thyroid surgery?

Thyroid surgery, also known as thyroidectomy, can be done in three ways

  • Total thyroidectomy: In this procedure, the entire thyroid gland is removed. It is typically performed in cases of thyroid cancer or some cases of hyperthyroidism.
  • Partial thyroidectomy: Also known as lobectomy, this procedure involves removing one lobe of the thyroid gland. It is usually performed when there are nodules or growths in only one lobe or if the condition affects only a specific part of the thyroid gland.
  • Subtotal thyroidectomy: This procedure involves the removal of a significant portion of the thyroid gland, leaving a small part intact. It is typically performed in cases of large goiters or Graves’ disease.

Thyroid

If your conditions meet the criteria and you are scheduled for surgery, you should avoid eating or drinking after midnight the day before surgery and leave valuables and jewelry at home. Thyroid surgery typically takes two to two and a half hours under general anesthesia. 

Surgery can be performed through a standard neck incision, minimally invasive surgery using a video camera, or with the assistance of a robot through a distant incision in either the axilla or the back of the neck. There may be a surgical drain in your neck incision, which will be removed after the surgery, and your throat may be sore as a result of the breathing tube inserted during the procedure. 

What needs to be done after the thyroid surgery?

Once you are fully awake in the recovery room, you will be allowed to have something light to eat and drink. Many patients having thyroid operations, especially after hemithyroidectomy, can go home the same day after a period of observation in the hospital. Some patients will be admitted to the hospital overnight and discharged the next morning.

After the process of thyroid surgery, proper post-operative care is essential for a smooth recovery which includes:

  • Pain management: Pain and discomfort are common after thyroid surgery, which can be controlled using pain medications prescribed by the physician.
  • Activity restrictions: It is important to limit physical activities and avoid strenuous exercise to reduce the risk of a post-operative hematoma and the breaking of the stitches in the wound closer. As a result, normal activities can resume on the first post-operative day, while vigorous sports and heavy activities should be avoided for at least 10 days to 2 weeks. 
  • Thyroid hormone replacement: If the entire thyroid gland is removed, lifelong thyroid hormone replacement therapy is necessary to provide thyroid hormones to your body. The physicians will prescribe the appropriate dosage of synthetic thyroid hormone medications to maintain hormonal balance throughout your life
  • Follow-up appointments: Regular follow-up appointments will be scheduled to monitor the healing process, assess thyroid hormone levels, and address any concerns or complications that may arise.

The total recovery time after thyroid surgery varies from person to person. In general, full recovery and resuming of normal activities may take several weeks to a few months. It is critical to carefully follow the instructions of your healthcare provider and seek medical attention if any unexpected symptoms or complications arise.

Thyroid surgery at Phyathai 1 International

Phyathai 1 International is available for the treatment of thyroid disorders, including thyroid cancer. We can provide you with various approaches from medications to minimally-invasive thyroid surgery by our specialists at the Internal Medicine Center, providing treatment that complies with the patient’s conditions and significantly improves the patient’s quality of life.

If you are concerned about your thyroid gland conditions, we recommend consulting with our specialist at the Internal Medicine Center of Phyathai 1 International, which opens daily from 8 am to 8 pm. To ensure the fastest procedure time, We recommend taking a reservation by phone at number (+66)2-201-4600 ext.2166-67 or by E-mail at [email protected].


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