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Thyroid Surgery

If Surgery is Necessary

Removing part or all of your thyroid gland may be the best way to treat your thyroid problem. If this is the case, Dr. Klotch will discuss the procedure with you. A complete physical exam may be done to prepare you for surgery. This exam may include a routine check of your blood and your heart and an x-ray of your chest.

Surgery can be done to remove a very large goiter or nodule, a hyperthyroid gland that can’t be controlled with medications, or a thyroid gland that may be cancerous. The amount of gland removed depends on several factors. Dr. Klotch will discuss these factors, what to expect during the procedure, and the possible complications of thyroid surgery with you.

Risks and Complications of Thyroid Surgery

As with any surgical procedure, thyroid surgery has possible risks and complications. Dr. Klotch will discuss them with you. They include some of the following:

  • Bleeding
  • Infection: rare
  • Damage to nerves in your voice box leading to temporary or permanent hoarseness
  • Permanent damage to the parathyroid glands, make them under active (hypoparathyroidism). Because these glands control the amount of calcium in your bloodstream, permanent calcium supplements may then be necessary
  • Complications with general anesthesia
  • Difficulty with airway

Experienced thyroid surgeons provide the best possible surgical outcome. For Dr. Klotch's thirty plus years of experience, permanent complications include:

  • Permanent nerve injury: less than 1% (.06%)
  • Permanent hypoparathyroid: 0.1%
  • Take back to surgery: bleeding or airway: @1/500 cases
  • Wound infection: 1/2000
  • One death secondary to a heart attack after discharge (1/ over 4,000 operations)

Scars are placed and closed cosmetically. They range for 1.25 to 2 inches in length with the average incision less than 1.5 inches in length.

The Surgical Procedure

During the procedure, an intra venous (IV) line provides you with fluids and medications. You’ll be given general anesthesia, so you’ll be asleep during the procedure. An incision is made in your neck, along a crease in your skin. Dr. Klotch may remove one half of the thyroid gland (lobectomy), most of the gland (subtotal thyroidectomy), or the entire gland (total thyroidectomy). Sometimes, the decision about how much of the thyroid to remove can’t be made until Dr. Klotch makes the incision and can see the area around the thyroid. Once the procedure is completed, the incision is closed with sutures.

When thyroid cancers are treated, lymph nodes are sampled. Depending on the extent of disease additional removal of lymph nodes may be required in the anterior neck, mediastinum, or either or both sides of the neck. The decision as to the extent of the node dissection is dependent upon the pathology and the extent of disease. The best choice for any patient can only be made by an experienced thyroid surgeon. Additional care requires the interdisciplinary action of an experienced team.

After the Procedure

You can usually begin to eat and drink normally the evening after the procedure, but you may still be a little queasy from the anesthesia. Once the anesthesia has worn off and you’re feeling up to it, you will be able to get up and walk around. You may be given oral medication for pain the first day or so, but discomfort is usually minimal. A sore throat and hoarseness are common and may last for a week or so after the surgery. During your hospital stay, you will be monitored for bleeding and to make sure your parathyroid glands are working normally. The stress of surgery may stun these glands for a short time, so you may be given calcium supplements for a few days.

In the Years to Come

Once your thyroid problems are under control, you can get back to doing the things you like to do. To keep feeling good, follow Dr. Klotch’s instructions closely. Take your medications or hormone pills everyday and see Dr. Klotch for regular checkups.

After you are feeling better, the right care can keep you feeling good. If you have been given thyroid hormone or other medications, take your pills regularly to help keep your thyroid hormone at the right levels and your body running smoothly. See Dr. Klotch as directed for regular blood tests. These test confirm that your hormone pills or medications are still at a dose that is right for you. If you have a nodule, monitoring may be necessary to check for changes in its size or for the appearance of additional nodules. If you have had treatment for cancer, regular exams help catch it early if it returns. No matter what the cause, thyroid problems do not have to keep you from feeling good and doing what you like.