Thyroid Surgery

Thyroid surgery is performed under general anesthesia. An incision of approximately two to three inches is made in the front of the neck. A single lobe or the entire thyroid can be removed during surgery. Total thyroid surgery is used when the entire gland is enlarged, if both lobes are affected, or if there is a fairly large tumor present. Partial removal (lobectomy) is used when there is a nodule affecting only one lobe.

The reason surgery is used when cancer is not confirmed is because it is often impossible to tell if a nodule is cancerous until it is removed. If a partial removal is performed and the nodule is determined to be cancerous, an additional surgery for complete removal might be ordered. Follow-up surgery is typically performed within a day or two of the initial procedure, once the pathologist has determined the removed portion is cancerous. Removal of lymph nodes might also be necessary.

Recovery

Lobectomies are usually performed on an outpatient basis. Patients undergoing total thyroid removal are required to stay at least one night in the hospital. This is so doctor’s can monitor calcium levels. The parathyroid glands found near the thyroid are responsible for calcium metabolism and can be separated during surgery. Before releasing a patient from the hospital, doctors must know that the function of these glands has not been affected.

Patients are permitted to eat and drink normally following surgery. They are encouraged to return to normal as soon as possible. Mild hoarseness and a sore throat following surgery are common. A follow-up evaluation is required about a week after surgery.

Possible Complications

Thyroid surgery is common and considered very safe, but as with any surgery, there are potential risks. These include:
  • Bleeding in the neck (this can be serious if the blood places pressure on the trachea)
  • Infection
  • Injury to the parathyroid glands as mentioned above
  • Injury to the vocal chords, which can cause temporary or permanent hoarseness
  • Complications related to anesthesia

Patients should contact their doctor if swelling at the incision site increases following surgery. Other potentially serious side effects include severe pain, signs of infection, such as a fever of more than 104 degree F, or bleeding. Tingling or cramping in the hands and feet could indicate low calcium and should also be brought to your doctor’s attention.