Thyroidectomy
Published by Bupa's health information team, June 2009.
This factsheet is for people who are having a thyroidectomy, or who would like information about it.
A thyroidectomy is an operation to remove all, or part, of your thyroid gland.
Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.
- The thyroid gland
- About thyroidectomy
- Diagnosis of thyroid disease
- What are the alternatives to thyroidectomy?
- Preparing for your operation
- About the operation
- What to expect afterwards
- Recovering from the operation
- What are the risks?
- Questions and answers
- Related topics
- Further information
- Sources
The thyroid gland
Your thyroid gland is found at the base of your neck, in front of your windpipe.
The location of the thyroid gland and surrounding structures
It's an endocrine gland, meaning that it secretes hormones into your bloodstream. It produces and secretes two hormones - triiodothyronine (also called T3) and thyroxine (also called T4). These hormones work together to control your metabolism (the speed of your body's processes).
About thyroidectomy
A thyroidectomy is an operation to remove all, or part, of your thyroid gland. If all of your thyroid gland is removed, it's called a total thyroidectomy. If only part of it is removed, it's called a partial thyroidectomy, sub-total thyroidectomy or lobectomy.
Thyroidectomy is used to treat several conditions. These are:
- an overactive thyroid gland (hyperthyroidism) - a condition where your thyroid gland is producing too much hormone
- an enlarged thyroid gland (goitre)
- cancer of your thyroid gland
- a cyst or benign (non-cancerous) lump on your thyroid gland
Diagnosis of thyroid disease
You will usually need to have blood tests to check the level of thyroid hormones in your blood.
If you have a tumour or enlarged thyroid gland, you may have an ultrasound scan. An ultrasound scan uses sound waves to produce an image of the inside of your neck.
You may also have a biopsy of your thyroid gland. This means that a small piece of your thyroid tissue will be removed, usually with a needle, and examined under a microscope.
What are the alternatives to thyroidectomy?
An overactive thyroid gland can sometimes be treated with medication or with radioactive iodine. Radioactive iodine is used to slowly kill your thyroid tissue. It's not suitable for pregnant women.
Cancer of the thyroid gland can sometimes be treated with radiotherapy or chemotherapy, instead of surgery.
Preparing for your operation
Your surgeon will explain how to prepare for the procedure. For example, if you smoke, you will be asked to stop as smoking increases your risk of getting a wound infection, which can slow your recovery.
If you have an overactive thyroid gland, you will be given some medicine (usually a drug called carbimazole) to take before your operation. This will slow down the production of thyroid hormones. You may also be given some medicine containing iodine to take for 10 to 14 days before your operation. This will reduce the size of your thyroid gland and its blood flow, helping to make the operation easier.
The operation will be done under general anaesthesia. This means you will be asleep during the procedure. You will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before you have a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
At the hospital, your nurse may check your heart rate and blood pressure and test your urine.
You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anti-clotting medicine called heparin as well as, or instead of, stockings.
Your surgeon or another healthcare professional will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
About the operation
The operation will usually take about two hours.
Once the anaesthetic has taken effect, your surgeon will make a cut into your lower neck. If you already have a crease in your lower neck, the cut will be made here for cosmetic reasons. Your surgeon will remove all or part of your thyroid gland. The cut will be closed with stitches or surgical clips afterwards.
What to expect afterwards
You will have a drip providing you with fluids, probably going into a vein in the back of your hand. You may have a fine tube (called a drain) running out from the wound when you first wake up after the operation. You may also have a catheter to drain urine from your bladder into a bag. These will usually all be removed the next morning, or within 24 hours.
You will have some pain and stiffness in your neck. Let your surgeon or a nurse know if you're in a lot of pain and they will give you some painkillers.
You can usually go home one or two days after your operation. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.
General anaesthesia temporarily affects your coordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you're in any doubt about driving, please contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon's advice.
Recovering from the operation
You may find it uncomfortable to swallow for a few days after your operation. It may help if you stick to soft foods during this time.
If your whole thyroid gland was removed, you will be given hormone replacement medicine to take. This will replace the hormones that your thyroid gland would usually make.
You may be given some painkillers to take home with you, to help to reduce the pain in your neck. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
You will be given some exercises to do to help reduce the stiffness in your neck. You will need to do these exercises until you can move as well as you could before the operation.
Your stitches or clips will usually be removed a few weeks after the operation. If you have dissolvable stitches, the amount of time it takes for them to disappear will depend on the type of stitches you have. They usually disappear in around two to three weeks, but it can sometimes take longer.
You should be able to carry out your usual activities once you are home, but don't overdo it. Avoid any strenuous activities and lifting for the first few weeks.
What are the risks?
Thyroidectomy is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
Side-effects
Side-effects are the unwanted but mostly temporary effects you may get after having the operation.
You will have a scar after the operation. It may feel a little tight or swollen to begin with.
You will have some pain and stiffness in your neck. You may be given some painkillers to take home with you to help reduce the pain. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
Complications
This is when problems occur during or after the operation. Most people aren't affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, infection, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis).
Complications specific to a thyroidectomy are listed here.
- The nerve to your voice box (larynx) could be damaged during the operation, giving you a hoarse voice. This will usually get better on its own.
- Your parathyroid glands could be damaged during the operation. If this happens, you may need to take calcium replacement medicine. You may also need to take vitamin D supplements.
- If there is a lot of bleeding you may need further surgery. This is very rare.
- Your wound could become infected. If your neck becomes increasingly red, swollen or painful or there is discharge coming from your wound, contact the hospital or your GP. Infections can usually be treated with antibiotics.
The exact risks are specific to you and differ for every person, so we haven't included statistics here. Ask your surgeon to explain how these risks apply to you.
Related topics
Further information
- British Thyroid Foundation
01423 709707
www.btf-thyroid.org
Sources
- The thyroid gland. Cancer Research UK. www.cancerhelp.org.uk, accessed 20 February 2009
- Thyroid surgery. British Thyroid Association. www.british-thyroid-association.org, accessed 20 February 2009
- Which surgery for thyroid cancer? Cancer Research UK. www.cancerhelp.org.uk, accessed 20 February 2009
- Economou SG, Economou TS. Instructions for surgery patients. 1st ed. Philadelphia: W.B. Saunders Company, 1999:611
- Simon C, Everitt H, and Kendrick T. Oxford handbook of general practice. 2nd ed. Oxford: Oxford University Press, 2005:421-23
- Tests for thyroid cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 23 February 2009
- Toft A. Understanding thyroid disorders: Family Doctor Series in association with The British Medical Association, 1998:9-11
- About chemotherapy for thyroid cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 20 April 2009
- Having your operation for thyroid cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 20 February 2009
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for advice from a qualified health professional.
Publication date: June 2009
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