General Questions About Thyroid Surgery
- What types of thyroid surgery are there? Is the whole thyroid always removed?
Thyroid lobectomy and isthmusectomy: this is when half of the thyroid (or one lobe) is removed along with the middle part of the thyroid that connects the two lobes. This surgery is generally performed for benign lesions that are causing symptoms, or for a nodule with an “indeterminate” biopsy for diagnostic purposes.
Total thyroidectomy: this is when the entire thyroid gland is removed. This surgery is performed for all known cancer cases, in patients with nodules in both thyroid lobes, and for Graves’ disease.
- What type of anesthesia will I have?
- How long does surgery take?
Surgery can take anywhere from one to six hours once you are asleep depending on the type of surgery you are having.
- How long will I be hospitalized?
Most patients that undergo a total thyroidectomy will spend one night in the hospital and go home the next morning.
Some patients that have only a thyroid lobectomy and live locally may be able to go the same day after six hours of monitoring in the recovery area.
- Will surgery affect my voice or cause any other side-effects?
One of the rare side effects of thyroid surgery is injury to one of the recurrent laryngeal nerve that controls your voice. This complication occurs in about 1-2% of patients.
It is not uncommon to experience some temporary hoarseness after an extensive surgery.
- Do you monitor the nerves that control the voice during surgery?
Yes. A nerve monitor is used during your entire thyroid operation. This allows the surgeon to confirm that the recurrent laryngeal nerve (the one that controls your voice) is working at the end of the case.
- When will I know the findings of the surgery?
The results of your final pathology can take up to seven business days. The surgeon will call you with the results if they are back in a few days. However, surgeon may not be able to discuss the results with you if there is a delay in final pathology report.
- Will I have a big scar?
While we perform minimal access surgery at USC and try to minimize the size of the incision, the final determination will depend on what type of surgery you are having, the size of your neck, and the size of your thyroid gland.
Most patients heal very well from surgery and have minimal residual scar at 6 months
It is important to apply suntan lotion to the surgical site for up to one year after surgery to prevent darkening of any scar.
- Will I have stitches?
You will not have any stitches that need to be removed.
- Will I have to take medication if I still have half of my thyroid?
Approximately 1/2 - 3/4 of patients that have half a thyroid will not need hormone replacement. However, there are no accurate predictors of who will need medication and who will not.
Your thyroid function will be tested about six weeks after surgery and a determination will be made at that time.
- Will I have to take medication if I have no thyroid?
Yes. You will have to take thyroid hormone replacement for the remainder of your life. It is a small pill that you take once a day (either first thing in the morning or before bedtime) on an empty stomach.
- How long is recovery? When can I go back to work?
Everyone can eat, drink, and talk that same day right after surgery.
While you may feel some fatigue for 2-3 days (general anesthesia), you will be able to perform your normal activities.
Most people only take a few days off from work.
- Will I need follow-up appointments once my thyroid gland has been removed?
You will be scheduled for a post-op visit 10-14 days after your surgery.
If the final pathology is benign, you only need to follow-up with your endocrinologist or primary care provider for monitoring of your thyroid function.
If the final pathology is cancer, then lifelong follow-up is needed with both your endocrinologist and with the surgeon.
Please refer to the American Association of Endocrine Surgeons patient education website for more detailed information: http://endocrinediseases.org/thyroid/index.shtml
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