Thyroidectomy Explained: Your Guide to Thyroid Cancer Surgery and What to Expect

Thyroid cancer involves tumorous cells in the butterfly-shaped gland, or the thyroid, located at the base of the neck. When diagnosed with thyroid cancer, one of the most common treatment options is thyroidectomy. It is a surgical procedure to remove part or all of the thyroid gland.

The thyroid is a gland that produces essential hormones for regulating metabolism, energy levels, weight, heart rate, blood pressure, and overall health. Consequently, the health of this gland must be addressed with the right kind of treatment, especially in the case of cancer.

This guide breaks down the thyroid cancer surgery process, recovery expectations, possible complications, and the role of hormone replacement therapy to offer readers clarity and confidence when they decide to go ahead with thyroidectomy.

If you notice the earliest symptoms, consult a specialist.

What Is a Thyroidectomy?

It is a type of thyroid cancer surgery in which the thyroid gland is removed, partially or wholly. The thyroid gland is one of the most essential glands in the human body, as it produces a hormone that regulates crucial biochemical processes in the body. The butterfly-shaped gland has right and left lobes and the thyroid isthmus that connects the lobes.

The process involves either the removal of the entire gland or a part of it. Thyroidectomy is advised not just for thyroid cancer but also in the case of hyperthyroidism (overactive thyroid), large goitres, and suspected thyroid nodules.

There are different types of thyroid cancer surgery –

• Partial thyroid lobectomy, where a part of the gland is removed. It is a rare procedure.
• Thyroid lobectomy, where one or all lobes of the gland are removed.
• Thyroid lobectomy with isthmusectomy, where one or all lobes are removed along with the thyroid isthmus.
• Subtotal thyroidectomy where one lobe, the isthmus, and partially the secondary lobe are removed.
• Total Thyroidectomy, where the entire gland is surgically removed.

Thyroid Cancer Surgery: Why It’s Recommended

Surgical procedures like thyroidectomy help remove the cancerous growth, reducing the risk of recurrence. After the procedure, doctors can examine the removed tissues and send them for testing to understand the spread of cancer. It also opens the path for the patient to receive follow-up therapies like thyroid hormone replacement after surgery.

Total Thyroidectomy Procedure

This procedure is advised for patients diagnosed with follicular or papillary thyroid cancer. This is because in these cases, there are more risks of the cancerous growth spreading within the gland or to nearby lymph nodes.

Before the surgery begins, your doctor will advise you to stop certain medications like anticoagulants or platelet inhibitors. You will have to fast for several hours before the actual time of surgery. Your medical history will be assessed for a better understanding of your body’s condition.

The total thyroidectomy procedure is usually performed under general anesthesia and takes about 2–3 hours.

Conventional Thyroidectomy

• Conventional thyroidectomy involves a small incision above the collarbones in the front portion of the lower neck.
• Once the thyroid gland is revealed, it will be cut free and removed from surrounding tissues. The whole gland is removed, ensuring the parathyroid glands and the laryngeal nerve are preserved.
• Once finished, the surgeon will close the incision with one or two stitches. A drain is placed near the site to reduce swelling and prevent fluid accumulation.
• After the surgery, your condition will be monitored in the recovery room. Once stable, you will be sent back to the hospital room.
• You will be allowed to go back home after one or two days post-surgery.

Endoscopic Thyroidectomy

• 2-4 tiny incisions are made, each approximately 3-5 mm long.
• A medical instrument called an endoscope and tiny surgical instruments are inserted through the incisions into your neck.
• A tiny camera at the end of the endoscope guides the surgeon to remove the thyroid tissue.
• After the procedure is over, the incisions are closed with surgical tape or tiny stitches.

What to Expect After Thyroid Surgery?

You will be discharged from the hospital after 1 to 2 days post-surgery. Some people experience mild discomfort, pain, soreness or stiffness of the neck or around the site.

Some patients also experience a hoarse voice after the surgery,

You will need to visit the doctor for a follow-up, where your incision site will be assessed. The scars will fade with time, and you may be able to return to your routine within 1 to 2 weeks of thyroidectomy surgery.

Remember, you need to undergo blood tests periodically to determine phosphorus and calcium levels. This helps you understand if the parathyroid glands are functioning correctly or not.

Thyroidectomy Recovery: Step-by-Step

First week

• You need to rest a lot. Focus on pain management and limit neck movement and physical strain.
• Ensure that the incision is clean and dry.

Weeks 2 – 3

• Start doing light activities
• Gradually go back to your daily routine
• Avoid heavy lifting

Weeks 4 – 6

• You can start exercising
• Start strenuous work
• Get back to full-scale activities
• Ensure regular follow-ups to monitor thyroid hormone and calcium levels

Thyroidectomy Complications

• Bleeding or hemorrhage from the wound. Consult the doctor immediately, as it can make breathing difficult.
• The laryngeal nerves could be injured, causing vocal cord paralysis or voice change.
• An increased level of thyroid hormones is a possible thyroidectomy complication. This is often called thyroid storm.
• The superior laryngeal nerve can be partly or wholly injured. It could affect your singing capacities.
• Wound infection due to the surgical incision is a complication.
• A common thyroidectomy complication is hypoparathyroidism or low calcium levels in the blood. This occurs if the parathyroid gland is damaged.

Thyroid Hormone Replacement After Surgery

The thyroid gland is an essential part of the body as it regulates metabolism. Removing it means your body can no longer produce essential thyroid hormones. That is why thyroid hormone replacement therapy becomes crucial – you would need it lifelong.

• Levothyroxine, a synthetic thyroid hormone, is prescribed to replace the hormones your thyroid would usually produce.
• It is initiated based on the patient’s weight and then adjusted based on regular blood tests (TSH levels).
• With proper medication, most patients lead completely normal everyday lives after thyroidectomy.

A thyroidectomy is a safe and effective procedure for removing cancer-affected thyroid tissues. Complications are minimal, and recovery is typically smooth. The success rate is relatively high, especially when followed by proper hormone replacement therapy. This therapy is lifelong but essential for a healthy you.

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