Thyroid surgery is performed to treat thyroid conditions such as nodules, cysts, goiter, or thyroid cancer. It can be either total or partial, depending on whether the entire gland or only part of it needs to be removed.
This procedure involves making a small incision in the neck to remove all or part of the thyroid gland. In most cases, it’s performed without complications, although temporary symptoms such as voice changes or coughing may occur.
Recovery after thyroid surgery is usually simple. It’s important to avoid strenuous activities to prevent swelling and bleeding at the incision site. The doctor may also prescribe hormone replacement therapy to keep thyroid hormone levels balanced.
When it is indicated
Thyroid surgery is recommended to treat thyroid cancer or suspicious nodules, helping remove tumors or clarify uncertain diagnoses.
It may also be indicated for hyperthyroidism, when the thyroid produces too many hormones and medications cannot control the condition.
Surgery may also be considered for goiter or benign nodules that cause discomfort or make swallowing or breathing difficult.
Types of thyroid surgery
The main types of thyroid surgery include:
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Total thyroidectomy: Complete removal of the thyroid gland.
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Partial thyroidectomy: Removal of only part of the thyroid, which may involve tissue from both sides.
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Lobectomy: Removal of one thyroid lobe and the isthmus, the tissue connecting both sides, leaving the other half of the gland functioning normally.
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Neck dissection: Removal of the thyroid along with nearby lymph nodes, typically performed in cases of medullary or anaplastic thyroid cancer.
The type of thyroid surgery depends on each person’s condition, the size and location of the thyroid problem, and the need to control or prevent complications.
How to prepare
Preparing for thyroid surgery involves taking specific precautions in the weeks and days before the procedure to ensure safety and promote recovery.
A few weeks before surgery, imaging tests such as ultrasound or CT scans may be done to locate the thyroid and evaluate vocal cord function. A biopsy may also be performed to confirm or rule out cancer.
People with hyperthyroidism may need medication or iodine treatment to help control thyroid function and reduce the risk of bleeding during thyroid surgery.
Certain medications should be avoided about 10 days before surgery, including aspirin, ibuprofen, naproxen, and vitamin E, since they can increase the risk of bleeding. On the day of surgery, fasting for 8 hours is recommended.
How it is done
Thyroid surgery is generally performed as follows:
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General anesthesia, usually administered intravenously
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Neck incision, made to access the thyroid gland
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Removal of the thyroid, which may be total, partial, or include nearby lymph nodes
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Closure of the incision, taking care to protect nearby structures such as nerves and blood vessels
The procedure typically lasts about 2 hours. Most people stay in the hospital for 1 to 2 days before receiving instructions for recovery at home.
Recovery after thyroid surgery
Recovery usually takes about 15 days. During this time, it’s important to avoid intense physical activities, such as running or lifting heavy objects, to prevent swelling or bleeding at the incision site.
After the procedure, a drain may be placed in the neck to remove excess fluid or blood and prevent hematomas.
Mild discomfort or pain is common and can be managed with pain relievers or anti-inflammatory medications such as acetaminophen or ibuprofen.
It’s also recommended to eat soft or liquid foods to make swallowing easier and reduce discomfort.
The incision is covered with a dressing to prevent infection and sun exposure and should not get wet. The dressing and visible sutures are usually removed about three days after surgery at the hospital.
How many days of rest are needed?
Most people don’t need complete bed rest. Light activities such as walking or office work can usually be resumed within a week, but strenuous exercise should be avoided until full recovery.
What happens after thyroid removal
Thyroid surgery rarely causes complications, but possible effects include:
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Sore throat and cough, which can make eating uncomfortable and usually improve within a week
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Voice changes, such as hoarseness or fatigue when speaking, which generally resolve within a few months, although voice therapy may sometimes be needed
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Low calcium levels in the blood, since the nearby parathyroid glands produce parathyroid hormone (PTH), which helps regulate calcium levels
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Neck hematoma, which can cause pain and swelling
Because the incision is made in the neck, it’s normal to have a thin scar that may range from 3 to 15 cm.
When the entire thyroid is removed, thyroid hormone replacement with levothyroxine is required for life, as prescribed by an endocrinologist, to maintain normal hormone levels.
If only part of the thyroid is removed, hormone replacement may not be necessary, as the remaining portion can often produce enough hormones for the body’s needs.
About one month after partial thyroid removal, the doctor will usually order blood tests and an ultrasound to check hormone levels and evaluate recovery.
Does thyroid removal cause weight gain?
Thyroid removal does not directly cause weight gain. However, if hormone replacement therapy is not properly managed, hypothyroidism may develop, which can lead to weight increase.
When only part of the thyroid is removed, the same can occur if the remaining gland doesn’t produce enough hormones. Regular blood tests and proper hormone replacement are essential to maintain a healthy balance.
Is thyroid surgery dangerous?
Thyroid surgery is considered a safe procedure, but like any surgery, it carries some risks, such as voice changes, bleeding, or fluctuations in calcium levels. These effects are usually temporary and can be effectively managed by a doctor.