Surgery may be the only option for certain patients with thyroid abnormalities.
Three major types of thyroidectomy:1. Total thyroidectomy- This is removal of all thyroid tissue with preservation of the recurrent laryngeal nerve and parathyroids. Patients will almost always require treatment for hypothyroidism after this type of operation
2. Unilateral thyroidectomy- This is when only one thyroid lobe is removed without surgical entry into the contralateral neck. Only some patients may need treatment for hypothyroidism afterwards, especially if there are already known to have Hashimoto's thyroiditis.
3. Isthmusectomy-
Only the middle portion of the thyroid is removed. Note that removal of only the abnormal portion (nodule) of the thyroid like removing a scoop of ice cream is not possible, especially if the reason for surgery is possible thyroid malignancy in a thyroid nodule.
Complications are rare and are lower in patients undergoing surgery by high-volume surgeons:1. Metabolic complications
2. Anatomic complications
References 1. Lee YS, Nam KH, Chung WY, Chang HS, Park CS Postoperative complications of thyroid cancer in a single center experience. J Korean Med Sci. 2010;25(4):541 2. Bentrem DJ, Rademaker A, Angelos P. Evaluation of serum calcium levels in predicting hypoparathyroidism after total/near-total thyroidectomy or parathyroidectomy. Am Surg. 2001;67(3):249 3. Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi PG, Pelizzo MR, Pezzullo L Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg. 2004;28(3):271 |
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