Patient Information & Education
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Thyroid
Surgery Information

Surgery of the thyroid gland may be required to establish a diagnosis, relieve pressure from an enlarged thyroid, or to remove cancer. It is performed under general anesthesia (the patient is completely asleep) and usually requires at least an overnight stay. The hospital stay may be longer, depending on individual circumstances. While there are exceptions, most thyroid surgeries take from 1 to 4 hours.

A thyroid lobectomy involves removal of the half of the thyroid that has a nodule with characteristics suspicious for cancer. While the patient is still asleep, a "frozen section" can be performed to analyze the tissue immediately. If this preliminary evaluation indicates a high likelihood of cancer, the remainder of the thyroid is usually removed. This is known as a total thyroidectomy. On the other hand, if the frozen section does not reveal cancer, surgery is limited to the half of gland already removed. At the follow-up visit, the final pathology results will be discussed with the patient. In some cases, the final result is different than the preliminary result, and reveals cancer, which can require additional surgery.

Surgery is performed through a single incision in the front, central area of the lower neck. The surgeon will make every effort to make the scar less visible, but healing often depends on patient characteristics over which the surgeon has no control. A drain tube is often placed  to prevent fluid accumulation under the incision. The drain can be removed the day after surgery, or sometimes remains in place for several days. Pain medications will be prescribed for use after surgery. Depending on the type of closure, sutures may be removed 5-7 days after surgery.

Complications of surgery are not common. Bleeding, infection, scarring, numbness of skin, need for further surgery, and risks of anesthesia are general risks related to most surgeries. Hoarseness and difficulty swallowing because of injury to the recurrent and superior laryngeal nerves (nerves to the voice box) occurs in less than 5% of cases. Hypocalcemia (low calcium) may occur from disruption of the blood supply to the parathyroid glands. This is usually temporary but may be permanent. This would require a lifelong daily calcium supplement. Some patients must take thyroid hormone replacement after surgery. If the entire gland was removed, this replacement will be permanent.

Instructions After the Procedure

• A follow up appointment should be made for 7 days after surgery
  
• Diet is usually normal by the time of discharge from the hospital
  
• Avoid lifting > 10 lbs, strenuous activity, and sports until approved by the surgeon
  
• Travel out of town is not recommended until after the first visit after surgery.
  
• The incision should be kept clean and dry for 48 hours, after which time the patient may shower. Apply antibiotic ointment twice a day for 3-5 days after surgery. Do not apply ointment on the day of your first visit to the office after surgery.
  
• Throat lozenges may be used for mild sore throat, hoarseness, or mild difficulty swallowing (these symptoms should improve in 3-7 days).
  
• Fever > 101.5 F should be reported to the physician if it does not improve with Tylenol (be aware that the prescribed pain medications already have Tylenol)

Following these guidelines will optimize your outcome after surgery.
Please call the office at (972) 402-8404 if you have any questions or concerns.