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Is it possible to live a full life after removal of the thyroid gland?
Thyroid diseases requiring surgical intervention are very common today: this is provoked by the environmental situation, genetic predisposition, iodine deficiency in areas and cities remote from the sea coast.
Until the end of the last century, doctors opposed the surgical removal of the affected thyroid tissue, because the gland plays a huge role in the hormonal background, and the lack of hormones produced by the thyroid gland leads to an imbalance in other hormonal organs of the system, mainly the pituitary gland. But after replacement therapy was developed – a method of regularly taking the synthesized hormone in the form of tablets, doctors began to treat the removal of the affected organ more loyally, and today thyroidectomy is performed very often, the operation is well-established, which makes it practically safe and painless. After surgery with complete or partial excision of gland tissues, patients have the opportunity to lead a full-fledged active life, maintain reproductive qualities, and play sports.
But do not forget that any surgical intervention in the body has a risk to the health and life of the patient, so the operation is performed only if the conservative intervention is considered unproductive. For example, if the patient’s body does not respond to the ongoing treatment, if there is a risk to life or the immune status of a person prevents the appointment of certain medications. In these cases, when thyroidectomy cannot be avoided, it is important to approach the choice of a surgeon with the utmost care, to study all contraindications for surgery and possible risks, so that the process goes through with a minimum amount of unpleasant sensations for the patient.
Indications for removal of the thyroid gland
There are two methods for removing the thyroid gland: complete, when the gland is completely excised, and partial, when the surgeon removes only the affected tissue. In order to determine which method is justified in a particular case, it is necessary to study the indications for each type of operation.
Complete thyroidectomy is performed if the following pathologies are diagnosed:
Oncological tumor of the gland, if there is more than one neoplasm in the tissues;
A goiter is an abnormal enlargement of the thyroid gland. The thyroid gland with toxic nodes is subject to removal, as well as non-toxic ones, if the goiter causes cosmetic defects in the neck or a feeling of squeezing the throat;
The presence of symptoms that aggravate the course of the disease: for example, ophthalmopathy caused by an excess of thyroid hormones in the body, an allergic reaction to drugs, an increase in the volume of the gland by more than 40 ml.
Partial thyroidectomy is indicated for:
Solitary tumors in the tissues of the gland;
Thyroid adenoma.
Surgical intervention is not performed when cysts are detected in the organ, since this pathology is solved in a different way, less dangerous and traumatic for the patient: ethyl alcohol is injected into the cyst by injection, which eliminates the problem quickly and efficiently. Also, the removal of nodes formed in the tissues without concomitant excision of the tissues surrounding the nodes is not carried out, since studies have emphasized the unproductiveness of this method of surgical intervention.
Examination before surgery
Before performing surgery, it is necessary to conduct examinations and tests that will help doctors get a complete picture of the patient’s health status, provide for all possible contraindications.
The preparation usually goes like this:
A clinical and biochemical blood test is examined, blood is taken for HIV, the Wasserman reaction, hepatitis, and the bleeding rate is determined. This list of tests is standard for any operation performed under both local anesthesia and general anesthesia. Blood parameters make it possible to assess the functioning of all systems and organs: kidneys, liver, heart.
The level of thyroid hormones in the patient’s blood is examined in order to assess the progression of the pathology and have data for comparison after surgery.
An ultrasound examination of the gland, vocal folds is performed.
Tests for tumor markers are carried out.
The therapist receives a conclusion, which indicates whether the patient is admitted to surgery for general health.
A biopsy of the gland nodes is performed by puncture with a thin needle through the front side of the neck.
In order to collect the entire necessary package of studies, a period not exceeding five days is sufficient. It is worth remembering that each analysis has a validity period, on average, an analysis is considered valid for two weeks. After all the test results are received, the patient is admitted to the hospital, and he undergoes surgical treatment.
Postoperative period
After the surgeon performs a thyroidectomy, the patient should remain under medical supervision for no more than three days if no complications have been identified. In some cases, hospitalization can last up to 7-10 days, for example, if the patient’s health condition is aggravated by certain diseases that can worsen after such a stressful factor for the body as a surgical operation.
In order for the postoperative period to be painless and successful, the patient needs to protect the suture area from injury. Pain, swelling and bruising rarely accompany a period of time after thyroidectomy, since a well-performed operation does not affect the crossed muscles, so the posture of damage is minimal so that the rehabilitation process goes quickly, painlessly, and comfortably. The seam on the skin is protected by a special silicone patch, which not only prevents infection or bacteria from entering, but also ensures rapid skin healing and minimizes aesthetic defects – adhesions, scars or scars. Also, a special glue is applied to the seam, which contributes to faster healing of the incision. In the event that the patient did not neglect the recommendations and protected the suture area from injury and dirt, scarring on the neck is unlikely to occur, or will be insignificant.
After the end of the hospitalization period, the patient should visit an endocrinologist who will select levothyroxine replacement therapy. The dose of the drug is calculated individually based on blood hormone tests. In order for the therapy to be carried out correctly, it is necessary to donate blood regularly, once every three to four months, to control the level of hormones. If the T4 level is below normal, the dosage of medications is increased, otherwise it is reduced. Dose fluctuations should not be more than 25 mcg in two weeks, but the correction scheme should be selected exclusively by the attending physician.
Tests after removal of the thyroid gland
In order to make sure that the surgical intervention was successful, it is necessary to pass tests after a thyroidectomy. Usually, blood is taken for the level of thyroid hormones, the amount of antibodies to thyroid peroxidase, tumor markers are examined.
With a properly performed operation without complications, the test results should normalize within a few weeks: the hormone level normalizes due to replacement therapy, antibodies do not exceed the permissible norm, and tumor markers give negative results. Some tests need to be repeated for several more months after surgery, for example, a test for the level of antibodies to peroxidase can fluctuate even with an existing pathology, so in order to make sure of remission, you need to have several tests confirming a positive outcome of the operation.
Consequences of removal of the thyroid gland
After removal of the thyroid gland or its fragment, the following consequences may occur:
Voice disorders – less than 1% of cases;
Hypocalcemia – less than 1% of cases;
Hematoma at the site of intervention – less than 0,02% of cases;
Early bleeding – less than 0,02% of cases;
Purulent complications – less than 0,001% of cases.
Gipotireoz
Hypothyroidism – a decrease in the level of thyroid hormones in the blood, is a natural consequence of the excision of thyroid tissue, because the organ that produces the hormone T3 and T4 has been removed, and there are no other sources of these hormones in the body. Hypothyroidism is not a disease, it is a characteristic of the state of the body with a deficiency of thyroid hormones, when all the processes in which the hormone is involved slow down. Currently, this condition is easily eliminated with the help of replacement therapy, which is the daily intake of tablets with a synthesized hormone on an empty stomach.
After the operation and the rehabilitation period, the patient’s quality of life does not differ from the life of any person, if the thyroidectomy was not burdened with complications. The operated person can lead an active lifestyle, play sports without any restrictions, travel, have children. The only restriction imposed by doctors is the daily lifelong intake of hormonal drugs that have no side effects and do not cause any changes in well-being, organ function, or metabolism, except for positive ones. Of course, in order for the consequences of the surgical intervention to be extremely positive, it is necessary to carefully approach the choice of a surgeon and a clinic that will deal with the surgical process and the patient’s rehabilitation.
After the operation, you can quickly return to your normal diet, which is not subject to any restrictions.
Removal of an organ affected by a disease makes it possible to obtain a disability, the group of which will be determined on an individual basis by the medical commission of the MSEC, which gives the right to receive various benefits, for example, when paying for utilities. But in this case, disability will have an exclusively formal character, since the person’s well-being will remain satisfactory, and the absence of an organ will not change the level of quality of life.