Thyroid gland removal
Total thyroidectomy; Partial thyroidectomy; Thyroidectomy; Subtotal thyroidectomy; Thyroid cancer - thyroidectomy; Papillary cancer - thyroidectomy; Goiter - thyroidectomy; Thyroid nodules - thyroidectomy
Thyroid gland removal is surgery to remove all or part of the thyroid gland. The thyroid gland is a butterfly-shaped gland located inside the front of the lower neck.
The thyroid gland is part of the hormone ( endocrine ) system. It helps your body regulate your metabolism .
Endocrine
Endocrine glands release (secrete) hormones into the bloodstream. The endocrine glands include:AdrenalHypothalamusIslets of Langerhans in the pancrea...
Metabolism
Metabolism refers to all the physical and chemical processes in the body that convert or use energy, such as:BreathingCirculating bloodControlling bo...
Description
Depending on the reason you are having your thyroid gland removed, the type of thyroidectomy you have will be either a:
- Total thyroidectomy, which removes the entire gland
- Subtotal or partial thyroidectomy, which removes part of the thyroid gland
You will have general anesthesia (asleep and pain-free) for this surgery. In rare cases, the surgery is done with local anesthesia and medicine to relax you. You will be awake, but pain-free.
General anesthesia
General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...
During the surgery:
- The surgeon makes a 3- to 4-inch (7.5 to 10 centimeters) cut in the middle of your neck, right on top of the thyroid gland. Or, the surgeon makes a smaller cut less than 2 inches (5 centimeters) long.
- All or part of the gland is removed through the cut.
- The surgeon is careful not to damage the blood vessels and nerves in your neck.
- A small tube (catheter) may be placed into the area to help drain blood and other fluids that build up. The drain will be removed in 1 or 2 days.
- The cuts are closed with sutures (stitches).
Surgery to remove your whole thyroid may take up to 4 hours. It may take less time if only part of the thyroid is removed.
Why the Procedure is Performed
Your doctor may recommend thyroid removal if you have any of the following:
-
A small thyroid growth (
nodule
or cyst)
Nodule
A thyroid nodule is a growth (lump) in the thyroid gland. The thyroid gland is located at the front of the neck, just above where your collarbones m...
-
A thyroid gland that is so overactive it is dangerous (
thyrotoxicosis
)
Thyrotoxicosis
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
-
Cancer of the thyroid
Cancer of the thyroid
Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located inside the front of your lower neck.
- Noncancerous (benign) tumors of the thyroid that are causing symptoms
-
Thyroid swelling (
nontoxic goiter
) that makes it hard for you to breathe or swallow
Nontoxic goiter
A simple goiter is an enlargement of the thyroid gland. It is usually not a tumor or cancer.
You may also have surgery if you have an overactive thyroid gland and do not want to have radioactive iodine treatment, or you cannot be treated with antithyroid medicines.
Overactive thyroid gland
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Risks
Risks of anesthesia and surgery in general include:
-
Reactions to medicines,
breathing problems
Breathing problems
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
-
Bleeding
, blood clots, infection
Bleeding
Bleeding is the loss of blood. Bleeding may be:Inside the body (internally) Outside the body (externally)Bleeding may occur:Inside the body when blo...
Risks of thyroidectomy include:
- Injury to the nerves in your vocal cords and larynx.
-
Bleeding and possible
airway obstruction
.
Airway obstruction
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
- A sharp rise in thyroid hormone levels (only around the time of surgery).
-
Injury to the parathyroid glands (small glands near the thyroid) or to their blood supply. This can cause a temporary low level of calcium in your blood (
hypocalcemia
).
Hypocalcemia
Ionized calcium is calcium in your blood that is not attached to proteins. It is also called free calcium. All cells need calcium in order to work. ...
- Too much thyroid hormone (thyroid storm). If you have an overactive thyroid gland, you will be treated with medicine.
Before the Procedure
During the weeks before your surgery:
-
You may need to have tests that show exactly where the abnormal thyroid growth is located. This will help the surgeon find the growth during surgery. You may have a
CT scan
,
ultrasound
, or other imaging tests.
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
-
Your doctor may also do a
fine needle aspiration
to find out if the growth is noncancerous or cancerous. Before surgery, your vocal cord function may be checked.
Fine needle aspiration
Fine needle aspiration of the thyroid gland is a procedure to remove thyroid cells for examination. The thyroid gland is a butterfly-shaped gland lo...
- You may also need thyroid medicine or iodine treatments 1 to 2 weeks before your surgery.
Several days to a week before surgery:
- You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil), naproxen (Aleve), clopidogrel (Plavix), warfarin (Coumadin).
- Fill any prescriptions for pain medicine and calcium you will need after surgery.
- Tell your health care provider about all the medicines you take, even those bought without a prescription. This includes herbs and supplements. Ask your provider which medicines you should still take on the day of surgery.
- If you smoke, try to stop. Ask your provider for help.
On the day of surgery:
- Follow instructions about when to stop eating and drinking.
- Take any medicines that your provider told you to take with a small sip of water.
- Be sure to arrive at the hospital on time.
After the Procedure
You will probably go home the day after surgery. In rare cases, you may need to spend up to 3 days in the hospital. You must be able to swallow liquids before you can go home.
Your provider may check the calcium level in your blood after surgery. This is done more often when the whole thyroid gland is removed.
You may have some pain after surgery. Ask your provider for instructions on how to take pain medicines after you go home.
You will likely be able to get up and walk on the day after surgery. It should take about 3 to 4 weeks for you to fully recover.
Follow any instructions for taking care of yourself after you go home.
Instructions
You had surgery to remove part or all of your thyroid gland. This operation is called thyroidectomy. You probably spent 1 to 3 days in the hospital....
Outlook (Prognosis)
Outcome of this surgery is usually excellent. Most people need to take thyroid hormone pills (thyroid hormone replacement) for the rest of their lives when the whole gland is removed.
References
Kaplan EL, Angelos P, James BC, Nagar S, Grogan RH. Surgery of the thyroid. In: Jameson JL, De Groot LJ, Giudice LC, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 96.
Smith PW, Salomone LJ, Hanks JB. Thyroid. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 38.
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Child thyroid anatomy - illustration
The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating the body's metabolism. Thyroid disorders are more common in older children and adolescents (especially in girls) than in infants. Most thyroid conditions can be treated medically, but occasionally surgery is required.
Child thyroid anatomy
illustration
-
Thyroidectomy - series
Presentation
-
Incision for thyroid gland surgery - illustration
The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating the body's metabolism. If surgery or an open excisional biopsy is needed, an incision is made in front of the neck to gain access to the thyroid gland.
Incision for thyroid gland surgery
illustration
-
Child thyroid anatomy - illustration
The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating the body's metabolism. Thyroid disorders are more common in older children and adolescents (especially in girls) than in infants. Most thyroid conditions can be treated medically, but occasionally surgery is required.
Child thyroid anatomy
illustration
-
Thyroidectomy - series
Presentation
-
Incision for thyroid gland surgery - illustration
The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating the body's metabolism. If surgery or an open excisional biopsy is needed, an incision is made in front of the neck to gain access to the thyroid gland.
Incision for thyroid gland surgery
illustration
-
Hypothyroidism
(In-Depth)
-
Thyroiditis
(Alt. Medicine)
Review Date: 2/27/2016
Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.