Thyroidectomy Surgery - Advanced Thyroid Removal

What to Expect After a Thyroidectomy?

After the surgery, the patient will have a drain in the neck. This drain is usually removed the morning after the surgery. Patients are discharged within 1-2 days of the surgery. The patient may have neck stiffness with a hoarse/weak voice temporarily after the surgery due to nerve irritation but that usually resolves on its own within a few days. 

You can go back to work within 5-6 days but you should wait at least 10-14 days before performing any vigorous activities. In the case of endoscopic and traditional surgery, there will be a small surgical scar on the neck that may take at least 8-10 months to fade.

The main long-term concern following a thyroidectomy (and parathyroidectomy) is hypocalcemia. If there is any preserved thyroid tissue, eventually, the thyroid levels can return to normal. However, in the case of total thyroidectomy, a patient will have to regularly take thyroid replacement hormones.

When is a Thyroidectomy Required?

Thyroidectomy may be recommended if the patient can’t tolerate anti-thyroid drugs or if they are pregnant. The amount of thyroid gland to be removed depends on the cause and severity of the thyroid disorder. The most common indications for thyroidectomy are:

• Thyroid cancer
• Noncancerous enlargement of the thyroid gland (goiter)
• Overactive thyroid gland (hyperthyroidism)
• The appearance of suspicious nodules on the thyroid gland 

How can Endoscopic Thyroidectomy Benefit you?

The primary benefit of endoscopic thyroidectomy is that it is minimally invasive and hence, results in very little surgical trauma to the tissues surrounding the thyroid gland. It is a safe and precise operation in which only the affected part of the thyroid gland is removed and the rest can be easily preserved.

Since the surgery is performed through the axilla, the patient’s neck remains scar-free and even on the axilla, the scars are barely noticeable and can be easily hidden under clothes. Since there is very little surgical trauma, recovery is quick, the patient heals much faster, and the chances of postoperative complications are very low.

What are the Complications Associated With a Thyroidectomy?

• Infection: Postoperative infections are rare after thyroidectomy but if they happen, they can delay healing. If there is increased pain, swelling, warmth, redness, pus drainage, or fever after the surgery, then it may be a sign of surgical infection.

• Seroma: Seromas occur due to fluid collections at the surgical site. When small, they disappear within a few weeks, but if they are large, they need to be surgically drained to prevent airway obstruction.

• Hypocalcemia (Hypoparathyroidism): Hypocalcemia, i.e.,  low blood calcium level, is a common side effect of thyroid/parathyroid gland removal. 

To manage this, patients have to take calcium supplements for at least one week after the surgery. At the first postoperative visit, blood calcium levels are checked and if normal, the patient can stop taking the supplements.

• Permanent hoarseness/Voice change: The recurrent laryngeal nerve is located in close proximity to the thyroid gland. If the nerves are irritated during the surgery, it can lead to temporary hoarseness, voice tiring, and weakness. It takes from a few weeks to six months to resolve. But if the nerve is damaged, then it will lead to a permanently hoarse voice.
• Airway obstruction: The patient may have breathing issues after the surgery due to compression of the trachea. It will usually resolve within the first 12-24 hours after the surgery, but if it persists, it can lead to hematoma formation and further health problems.

How can I Improve Recovery After a Thyroidectomy?

Once your surgery has been completed, you can improve your recovery by following the given tips:

• Take care of your incision. Any infection can delay healing and lead to further complications.
• Take calcium supplements for at least a couple of weeks after the surgery.
• Consult your doctor before taking a shower or swimming.
• Apply ointments on the scar to prevent it from drying and scabbing.
• Do not lift any heavy objects or perform any strenuous tasks for a couple of weeks.
• While your surgical site is stiff, you should consume foods that are soft and easy to swallow.
• Drink plenty of water during and after meals to soften the food and prevent blockages.
• If you are undergoing total thyroidectomy, then you may need thyroid hormone replacements.

Facts and Statistics Around Thyroidectomy:

• Thyroidectomy generally has a success rate of over 90%.
• The two most common early complications of thyroid surgery are hypocalcemia (occurs in 20-30% of patients) and recurrent laryngeal nerve injury (occurs in 5-11% of patients).
• Thyroidectomy does not shorten life expectancy.
• Around 42 million people in India are currently suffering from thyroid disorders. Out of these, hypothyroidism is the most common thyroid disorder in India, affecting one in ten adults.
• Thyroidectomy is one of the safest and most effective treatments for Grave’s disease.

Types of Surgery Based on the Severity of the Disease

• Total thyroidectomy  (TT)

Total thyroidectomy is the removal of the entire thyroid gland. It is most commonly performed for thyroid cancer, but it can also be performed for uncontrolled hyperthyroidism and goiter.

• Subtotal thyroidectomy (STT)

In a subtotal thyroidectomy, the surgeon leaves a small portion of the thyroid gland (about 4-5 grams) to preserve the body’s natural thyroid function and to lessen the need for thyroid replacement supplements in the future.

• Thyroid lobectomy (Hemithyroidectomy)

It is the removal of an entire lobe of the thyroid gland, leaving the other one intact. It is usually performed to manage hyperthyroidism or if the nodules/lumps are limited to one lobe.

• Thyroid isthmusectomy

Thyroid lobectomy with isthmusectomy involves the removal of a thyroid lobe with the isthmus (the part that connects both the lobes) in patients with unilateral thyroid cancer to ensure all the cancerous tissues have been removed.

Types of Surgery Based on Surgical Technique

Conventional thyroidectomy

Conventional/traditional thyroidectomy is the most common approach for thyroid surgery. The surgeon makes an incision on the neck to directly access the thyroid gland. 

Transoral thyroidectomy

During the transoral approach, the surgeon does not make any incisions externally, so it is aesthetically better. The surgical instruments are inserted through the mouth and the incisions are performed internally.

Endoscopic thyroidectomy

Endoscopic thyroidectomy is a minimally invasive procedure in which the surgeon makes tiny incisions on the neck and the surgical instruments (including a small endoscope) are inserted through these incisions. The camera helps guide the surgical instruments and perform the surgery with minimum damage to the surrounding tissues.

What is Cost of Thyroidectomy in India?

The average cost of thyroidectomy in India is Rs.82500. However, the cost is variable and depends on the individual characteristics of the patient. Some factors that affect the cost of thyroidectomy are: Choice of treatment city and hospital Type of surgery, based on surgical approach Patient’s age, gender and health condition Amount of thyroid tissue to be removed Post-surgical care and complications Surgeon’s experience and fees Cost of diagnostic tests Insurance coverage.

Consult with best ENT surgeon at Pristyn Care and get the cost estimate of Thyroidectomy surgery.