The most frequent to proceed thyroid surgery indications are: diffuse increase in the gland (goiter), increased localized part of the gland (nodule) and thyroid tumors. There are also other less common indications.
As for other operations, any patient who is going to perform a thyroidectomy should be evaluated preoperatively with a medical history and physical examination complete. Any patient who has had a change in voice, or has had a previous neck operation should have a pre-operative vocal cords called laryngoscopy evaluation.
What risks involves thyroid surgery?
The most important risks of thyroid surgery include: bleeding, recurrent laryngeal nerve damage that can cause permanent hoarseness, and damage to the parathyroid glands that control calcium levels in the body, causing hypoparathyroidism. In general, the risk of any complication should be less than 2%. However, the risk of complications is discussed with the patient should be the surgeon in particular, and no risk cited in the literature.
How we proceed to thyroid surgery?
Patients should discuss with the specialist in Otolaryngology what type of thyroid operation is to be performed, thyroidectomy or total thyroidectomy, and the reason why is recommended. Total thyroidectomy is the method of choice for the treatment of patients with multiple benign nodules and / or large goiters. For patients with unilateral nodules, thyroidectomy is the treatment of choice, provided that the patient is informed that if the pathology report of the surgical specimen is the tumor should be removed other thyroid lobe. In some medical centers during surgery a biopsy is done so that in the event that the diagnosis is of tumor, surgical treatment is completed with a total thyroidectomy. The intraoperative biopsy indication depends on the service of Pathology of the center where the surgery is performed, and today is not recommended for use by the high number of false negatives. For patients with hyperthyroidism due to Graves' disease should be performed total thyroidectomy. In any case, no subtotals or Graves disease or multinodular goiters thyroidectomies be performed.
The surgery usually takes two to three hours. It can be left surgical drainage depending on the custom of the surgeon and how aggressive intervention has been. Most patients undergoing thyroid surgery remain hospitalized between two and three days. activities that require physical effort for ten days should be avoided.
What is the process of recovering from thyroid surgery?
In the event that total thyroidectomy is performed, the patient should take the hormone produced by the gland (thyroxine) the rest of his life but, in general, thyroid hormone levels to normal in a few months. Thyroid hormone can also be used as suppressive therapy to prevent the growth of thyroid tissue that may remain after an incomplete and in some cases of thyroid tumor surgery.
Thyroid hormone is easy to take. As remains in the body for a long period of time, you can be administered once a day. The best time to take thyroid hormone is first thing in the morning on an empty stomach. It is very important that levels of TSH and thyroid stimulating hormone (thyroid gland) are periodically hormone controlled so that the dose can be adjusted if necessary.
Quite often the patient may have a state of hypocalcemia secondary to manipulation of the parathyroid glands or involuntary or removal during thyroidectomy. In the first situation, hypocalcemia will be temporary and the patient should take calcium associated with vitamin D for some time until blood calcium levels normalize. In the second situation, hypocalcemia is irreversible and the patient should take calcium, vitamin D and parathyroid hormone permanently.