Patient education: Thyroidectomy (The Basics)

What is thyroidectomy? — Thyroidectomy is the medical name for surgery to remove all or part of the thyroid gland. The thyroid is a gland in the middle of the neck (figure 1). It makes thyroid hormones, which help control how the body uses and stores energy.

This surgery can be done in 2 ways:

●Hemi-thyroidectomy – The doctor removes either the right or left half of the thyroid.

●Total thyroidectomy – The doctor removes the entire thyroid.

Why do I need to have my thyroid removed? — Your doctor might recommend this surgery if you have a problem with your thyroid gland. Examples include:

●Thyroid cancer

●Enlarged thyroid, or growths called "nodules" on your thyroid

●Hyperthyroidism, which is when your thyroid makes too much thyroid hormone

How do I prepare for thyroidectomy? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam, including checking your larynx (voice box) carefully. You might need to take medicines before surgery. The doctor might also send you to get tests, such as:

●Thyroid hormone levels and other blood tests

●Ultrasound, CT scan, MRI, or other imaging tests (imaging tests create pictures of the inside of the body)

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●Lowering the risk of infection – In some cases, you might need to trim (not shave) your body hair before your procedure. You might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during thyroidectomy? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Local – This type of anesthesia uses medicine to numb a small part of your body so you don't feel pain.

•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will make a cut, or "incision," in the skin over the front of your neck. Then, they will remove all or part of your thyroid. The doctor might use special monitors during surgery to make sure that they don't injure any of the nerves in your neck.

●The doctor will send the thyroid (or the part they removed) to the lab for further testing.

●The doctor will close your cuts (incisions) and cover them with clean bandages.

●The surgery will take 1 to 2 hours.

What happens after thyroidectomy? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. Some people can go home the same day of their surgery. Others spend a night in the hospital.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●If you had a drain tube in your neck, it will be removed.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of thyroidectomy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding, or fluid collecting under the skin near the incision

●Infection

●Low blood calcium or thyroid hormone levels

●Hoarseness, or change in voice

●Injury to tissues or nerves near the thyroid

●Trouble breathing or swallowing

What else should I know? — Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

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Patient education: Hyperthyroidism (overactive thyroid) (The Basics)
Patient education: Hypothyroidism (underactive thyroid) (The Basics)
Patient education: Nodular goiter (The Basics)
Patient education: Thyroid cancer (The Basics)
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Patient education: Thyroid nodules (Beyond the Basics)
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