Thyroid operations – indications, preparation, complications and convalescence. What thyroid surgery can be performed?

Contents

Indications for thyroid surgery
Preparation for thyroid surgery
Types of thyroid surgery
Possible complications after removal of the thyroid gland
Convalescence after thyroid surgery
Life after complete removal of the thyroid gland

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Diseases and disorders of the thyroid gland have already become the plague of the XNUMXst century. Diagnosed especially in young women, they usually do not require surgery, but sometimes surgery is necessary. What are the indications for thyroid surgery?

Indications for thyroid surgery

The thyroid gland is an odd endocrine gland located in the neck. Its task is to produce hormones such as triiodothyronine (T3), thyroxine (T4) and calcitonin. The work of the thyroid gland affects many functions of the body, especially the metabolism and the calcium-phosphorus balance. Disorders in the functioning of the thyroid gland are common today, and most respond well to conservative treatment. However, there are situations when surgery is necessary. These are:

malignant tumor (thyroid cancer);
thyroid goitre of a size so large that it constricts the airways or adversely affects the patient’s appearance;
complicated hyperthyroidism;
no effects of pharmacological treatment.

Symptoms that may suggest thyroid disorders depend on the condition in question. In the case of an overactive gland, it is primarily a constantly increased heart rate, weight loss despite the lack of changes in the diet, feeling hot, excessive sweating. The symptoms are different hypothyroidism. These include the constant feeling of sleepiness and fatigue, weight gain despite not changing the diet, feeling cold and hair loss. The symptom of a goiter in the thyroid gland there is a lump in the neck, sometimes only felt by touch.

Zobacz: Enlarged thyroid gland – causes, treatment

Preparation for thyroid surgery

Before thyroid surgery it will be necessary to adjust the levels of individual hormones secreted by the gland if they remain at inappropriate levels. The treatment that is appropriate for a given patient will be proposed by the attending physician. Before the procedure, it is necessary to perform tests to check the general condition of the patient. These include:

blood count;
serum electrolytes;
urea and creatinine;
glucose concentration;
basic parameters of the coagulation system (APTT, PT, INR);
general urine test.

As in the case of other surgeries, also on the day of the procedure you should be on an empty stomach. This means that you must stop eating solids 8 hours, and liquids 4 hours before the procedure.

Types of thyroid surgery

Depending on how advanced the patient’s condition is, the doctor may excise part or all of the gland. This decision must be preceded by numerous specialist tests, such as Thyroid ultrasound, scintigraphy, and if a tumor is detected – biopsy. The most conservative procedure is the removal of the thyroid lobe (strumectomy). This procedure is usually performed after the diagnosis of a follicular tumor in one of the lobes. After the surgery, it is necessary to carry out a histopathological examination. If the lesion turns out to be malignant, the procedure will have to be extended to include the removal of the second flap and local lymph nodes.

So-called subtotal thyroidectomy (Subtotal Stream) is the excision of both lobes along with the thyroid nodule. The indications for this procedure are hyperactive nodular goitre, nodular nodular goitre, and neutral and overactive parenchymal goitre, and goiter in the course of thyroiditis (e.g. in Hashimoto’s disease). Subtotal strumectomy is the most common thyroid surgery performed. In its course, only those parts of the thyroid lobes are removed that contain disturbing changes – depending on the given case, it is from 50 to 90% of the gland’s volume.

Total thyroidectomy (thyroidectomy) is a serious procedure, which mainly qualifies patients with tumors of the thyroid gland. The indications for this procedure are also goitre characterized by a nodular structure, some goitre in the course of Hashimoto’s disease, and some recurrent goitre. Thyroidectomy is a complicated procedure that should be performed only in reputable, highly qualified facilities.

Possible complications after removal of the thyroid gland

The operation of the thyroid gland is not indifferent to the patient’s well-being, especially if it covers a large part of the gland or its entirety. Serious complications after the procedure appear rarely – the frequency of their occurrence does not exceed 5%. Postoperative hypoparathyroidism occurs much more frequently, which is the result of a decrease in the level of calcium in the serum. Symptoms include tingling in the fingers and around the mouth, but they can be prevented by measuring the level of parathyroid hormone in the serum after the procedure, and by administering calcium and vitamin D3 supplements to the patient. It should be remembered that any disturbing symptoms occurring after the procedure (such as fever) should be immediately reported to the doctor.

Convalescence after thyroid surgery

After the operation, you should remain under the care of an endocrinologist. Necessity of supplementation, among others thyroxine in the right dose, which will be modified over time, makes the patient wait for visits and control tests. They are key to developing proper postoperative management.

The exact recommendations depend on various factors, including the scope of the procedure and the technique used by the surgeon. The patient should be given all directions before going home from hospital. The return to full fitness usually takes place after two weeks. During the convalescence period after the thyroidectomy, you should give up strenuous physical exertion.

Check: Thyroid doctor – endocrinologist or thyroidologist?

Life after complete removal of the thyroid gland

You should know that thyroid surgery is one of the treatment stagesand not its finial. The larger the area of the gland is cut, the greater the risk of permanent hypothyroidism (in the case of people after thyroidectomy it is 100%). This means that most patients after thyroid surgery have to take medication for the rest of their livesaimed at replacing thyroxine.

Due to the fact that hypothyroidism is associated with weight gain, in addition to taking the hormone-regulating preparations recommended by the doctor, it is also worth remembering about a proper diet. It does not have to be restrictive, but properly balanced and adapted to the level of physical activity of the patient. It is good if the menu includes lean meat, fish (wild salmon, cod), shrimp and vegetable fats such as olive oil, grape seed oil and avocado. Recommended vegetables and fruits are cauliflower, broccoli, Brussels sprouts, asparagus, cucumbers, kohlrabi, radish, eggplant, spinach, tomatoes, kiwi, blueberries, raspberries and blackberries.