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Thyroidectomy


 

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There are two sides of thyroid called lobes lay on either side of the trachea and is connected by thyroid tissue known as an isthmus. Some people might not have an isthmus and have two separate thyroid lobes.  The thyroid is the part of the endocrine system made up of glands which produces, stores and releases hormones into the bloodstream that reach the body’s cell. The two hormones made by thyroid are thyroxine (T4) and other is triiodothyronine (T3).  Thyroid problems are more common in women than in men. 


Hyperthyroidism - When too much of the thyroid hormones are secreted, body cells work faster than normal, it is called hyperthyroidism or thyrotoxicosis. Overactive thyroid causes the body’s metabolic functions to speed up resulting in adverse effects for example faster heart rate or increased activity of the intestine causing frequent bowel motions or diarrhea. Some of the symptoms of hyperthyroidism are:
Decrease or increase appetite
Insomnia
Fatigue and tiredness
Diarrhea
Heart palpitations
Increased sweating
Missed or light periods
Breathlessness
Fertility problems 
Sudden paralysis
Irritability
Thinning of hair
Weight loss or weight gain

Hypothyroidism - When thyroid gland produces less and insufficient thyroid hormone, it is called hypothyroidism or underactive thyroid. It causes body’s metabolic functions to slow down and have many adverse effects on bodily functions for example sluggish function of intestine causing constipation. 

Some of the symptoms of hypothyroidism:
Tiredness or fatigue
Dry skin
Weight gain
Constipation
Swelled up face
Hoarse voice
Muscle aches and stiffness
Heavy or irregular periods
Hair thinning
Depression
Impaired memory

A thyroidectomy is a surgical removal of all or part of the thyroid gland to treat the diseases of thyroid gland that include thyroid cancer, hyperthyroidism, multi-nodular goiter, large goiter or thyroid nodules etc. the amount of thyroid gland to be removed during thyroidectomy depends on the thyroid problem or disease. 
Partial thyroidectomy - when only a portion of thyroid is removed and rest of the thyroid may function normally after the surgery.
Total thyroidectomy – when the entire thyroid is removed. This requires regular treatment of thyroid hormone to replace the natural functions of thyroids. 
Thyroid lobectomy – all thyroid lobe is removed
Thyroid lobectomy with isthmusectomy – one thyroid is removed together with the thyroid isthmus. 
Subtotal thyroidectomy – one thyroid lobe, the isthmus, and a part of the second lobe are removed in subtotal thyroidectomy. 

Patient is recommended to avoid any medications or blood thinners to minimize any risk of bleeding. Doctor will review all the medical reports and surgical history of the patient. If a patient is pregnant or suspect to be pregnant, it should be informed to the doctor before surgery.  Thyroidectomy can be performed through conventional method or through endoscopic method.  In both the procedure, patient is given general anesthesia and other fluids or medications through intravenous line (IV). 
Conventional or traditional thyroidectomy – surgeon will make incision through the skin to expose the thyroid gland and other deeper structures to remove all or a part of the thyroid gland from the surrounding tissues. The incisions will be closed with stitches and sterile paper tapes. A small suction tube may be placed near the incision to drain any excess and accumulated blood inside the neck.  Patient will be shifted to recovery room for monitoring and suction tube will be removed after 24 hours. Most patient can go back home after a day or two.
Endoscopic thyroidectomy – surgeon will insert a thin probe with tiny camera at the end called endoscope into the neck through few small incisions that guides the instruments to remove the thyroid tissue. The incisions will be closed with stitches or surgical tape. 

Post surgery, patient can go back home after couple of days depending on the health condition. Regular follow up with doctor is recommended to check the healing of the incision. After the surgery, doctor will check the thyroid hormone levels, phosphorus or calcium levels by performing some blood tests. In case, of total removal of thyroid glands, patient may need to take hormone supplement for lifetime. 

Thyroidectomy also involves some potential risks and complications that may include:
Unexpected bleeding
Infection at incision site
Obstructed airways due to bleeding
Hoarse or weak voice caused by nerve damage
Hypothyroidism can occur if parathyroid glands are removed mistakenly
Reaction to anesthesia

Doctor should be informed immediately if patient develop:
High fever
Swelling or redness 
Husk or weak voice
Numbness around the mouth
Tingling or spasm in feet hands or face.

 

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