Thyroid Surgery

The thyroid gland is a small organ with hormonal function located in the anterior region of the neck. The most common diseases of the same are inflammatory ( thyroiditis ), those derived from increased hormonal function ( hyperthyroidism ) or descent ( hypothyroidism ) and both benign and malignant tumors ( thyroid nodules ).

In global terms, both thyroiditis and functional alterations and benign nodules of small size have medical treatment by an endocrinologist, indicating surgery in some specific cases. In circumstances of nodules with growth, which cause symptoms of local compression or pose reasonable doubts of malignancy, surgery will be indicated. In all cases of certainty of malignancy surgery will be equally indicated as the first treatment option.

Surgical treatment will depend on the pathology to be treated and may involve the removal of one side or lobe of the thyroid, right or left ( hemithyroidectomy ) or of the entire gland ( total thyroidectomy ).. Sometimes, to reduce the incidence of some complications, it is possible to leave small remnants of the gland (subtotal or near total thyroidectomy).

In general, the surgical results, in the medium and long term, of all thyroid diseases are very satisfactory. Regarding complications in the immediate postoperative period , the permanent advance of medicine and the frequency of these diseases has led to a gradual decrease in surgical mortality to figures of less than 1%. Regarding morbidity, this continues to be the main lack of function of the recurrent nerves that leads to a change, temporary or definitive, of the timbre of the voice and the decrease in calcium levels, generally temporary, due to lack of activity of the parathyroid glands. The appearance of these complications may be due to several factors such as the size of the thyroid, a history of previous cervical surgery or the presence of a malignant lesion. A fourth factor lies in the experience of the surgeon who, if there is one, can reduce the number of cases by up to 50%, in addition to reducing surgical time.. The most serious complication during the immediate postoperative period is hemorrhage in the operated cervical region that can force an immediate surgery to avoid tracheal compression symptoms. Although it is very rare, its potential severity requires close observation during the first 8-12 postoperative hours, being exceptional 24 hours after the intervention.

In conclusion, as in any surgery, a complete preoperative analysis that assesses the risk factors of the patient, both specific and their pathology to intervene, is the best prevention of future complications. Surgically, the experience of the medical team will be decisive in the reduction, not complete cancellation, of the same. Postoperatively, a strict clinical and analytical control will help to diagnose precociously most of them, which will minimize the subsequent consequences derived from them.