Thyroidectomy

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A thyroidectomy is an operation involving surgical removal of all or part of the thyroid gland. General Surgeon, Endocrine or Head and Neck often perform thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland (such as hyperthyroidism) or goitre. Other indications for surgery include cosmetics (enlarged thyroid), or symptomatic obstruction (causing difficulty in swallowing or breathing). Thyroidectomy is a common surgical procedure that has some potential complications or sequelae symptoms including: temporary or permanent changes in sound, temporary or low permanent calcium, the need for lifelong thyroid replacement, bleeding, infection, and possible distances from airway obstruction due to bilateral vowels cable paralysis. Complications are rare when the procedure is performed by an experienced surgeon.

The thyroid produces several hormones, such as thyroxine (T4), triiodothyronine (T3), and calcitonin.

After removal of the thyroid, patients usually take the determined oral synthetic thyroid hormone - levothyroxine (Synthroid) - to prevent hypothyroidism.

Extreme thyroidectomy variations include:

• "hemithyroidectomy" (or "unilateral lobectomy") - only removes half of the thyroid
• "isthmectomy" - removes the tissue band (or isthmus) connecting the two thyroid lobes

"Thyroidectomy" should not be confused with the "thyroidotomy" ("thyrotomy"), which is cut into the thyroid (-otomi), not the omission (- ectomy) from it. Thyroidotomy may be performed to gain access to median laryngomy, or to perform a biopsy. (Although biopsy technically involves the removal of some tissues, this is more often categorized as -otomy than ectomy because the volume of tissue removed is very small.)

Traditionally, the thyroid has been removed through a neck incision that leaves a permanent scar. More recently, minimally invasive and "no trace" approaches such as transoral thyroidectomy have become popular in some parts of the world.

Video Thyroidectomy

Indication

• Thyroid cancer
• Toxic thyroid nodules (produce too much thyroid hormone)
• Multinodular goiter (enlarged thyroid gland with many nodules), especially if there is compression of nearby structures
• Graves' disease, especially if there is exophthalmos (protruding eye)
• Thyroid nodules, if the results of fine aspiration (FNA) are unclear

Maps Thyroidectomy

Type

• Hemithyroidectomy - All isthmus is removed along with 1 lobe. Performed on benign disease only in 1 lobe.
• Subtotal thyroidectomy - The removal of most of the two lobes leaves 4-5 grams (equivalent to the size of the normal thyroid gland) of the thyroid tissue on one or both sides - this is used to be the most common operation for multinodular goitre.
• Partial thyroidectomy - Removal of the gland in front of the trachea after mobilization. Conducted in MNG is not toxic. His role is controversial.
• Total thyroidectomy pain - Both lobes are excluded except for small amounts of thyroid tissue (on one or both sides) around the receptor laryngeal point and superior parathyroid gland.
• Number of thyroidectomies - The entire gland is removed. Performed in cases of papillary or thyroid follicular carcinoma, medullary carcinoma of the thyroid gland. This is now also the most common operation for multinodular goiters.
• Hartley Dunhill operation - Appointment of 1 lateral lobe with isthmus and partial/subtotal removal of opposite lateral lobe. Conducted in MNG is not toxic.

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Complications

• Hypothyroidism in up to 50% of patients after ten years.
• The laryngeal nerve injury in about 1% of patients, especially recurrent laryngeal nerves: unilateral damage produces hoarseness. Bilateral damage appears as laryngeal obstruction after surgery and may become a surgical emergency: an emergency tracheostomy may be required. Recurrent laryngeal nerve injuries can occur during the binding of the inferior thyroid artery.
• Temporary (temporary) hypoparathyroidism in many patients, but permanent in about 1-4% of patients
• Anesthesia complications
• Infection (approximately 2%. Drainage is an important part of treatment.), a possible increased risk with the use of chronic preoperative steroids.
• Stitch granuloma
• Chyle leak
• Haemorrhage/Hematoma (This can compress the airway, become life-threatening.)
• Parathyroid removal or devascularization

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See also

• List of operations by type

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References

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External links

• The patient's leaflet from the American Thyroid Association
• Thyroid Surgery and Minimally Invasive Total Thyroidectomy from the New York Thyroid Center
• The article in Endocrineweb, written by MD Goes becomes more detailed
• The image of the initial postoperative scar
• Tutorial of Thyroid Surgery From Patient Education Institute
• Minimally invasive thyroid surgery and daily surgery Comprehensive information from the English Surgery Specialist

Source of the article : Wikipedia