What is a thyroidectomy?

The thyroid gland is a structure in your neck that produces a hormone called thyroxine, which regulates your body's metabolism.

A thyroidectomy involves removing all or part of your thyroid gland. Your surgeon may also recommend removing the lymph nodes from around the thyroid gland or in the side of your neck.

Thyroid cancer is a harmful growth that starts in the tissue of the thyroid gland.

Thyroid cancer may spread to the lymph nodes (glands) in your neck, and to other areas of your body such as your lungs or bones. Depending on the type of thyroid cancer, you may need further treatment such as radiotherapy or chemotherapy.

What are the benefits of surgery?

Surgery is recommended so that your doctor can be sure about what is causing the lump.

A thyroidectomy gives you the best chance of being free of cancer. You will no longer have the lump in your thyroid gland and any symptoms caused by the swelling should improve.

The thyroid tissue that your surgeon removes will be examined under a microscope to find out if cancer is present and if it is, which type. This will help decide on any further treatment.

Are there any alternatives to surgery?

If cancer is suspected, surgery is the only dependable way of confirming the diagnosis. If cancer is present, surgery also gives you the best chance of being free of thyroid cancer.

What will happen if I decide not to have the operation?

The lump may stay the same size or it could continue to grow and become more noticeable. It may affect your breathing or swallowing, and there is a risk that you will develop serious complications. Without surgery these complications could be life-threatening.

If the lump is caused by a cancer, there is a risk that the cancer will spread to other parts of your body. This can make the cancer harder to treat and can also be life-threatening.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes 1 to 2 hours depending on which type of thyroidectomy you are having.

Your surgeon will make a cut on your neck in the line of one of your skin creases.

Your surgeon will remove part, or all, of the thyroid gland. If necessary, they will remove any lymph nodes from around your thyroid gland through the same cut. Sometimes your surgeon may find other problems which they may be able to treat during the operation.

They will stitch the deep tissues and close your skin to leave a neat scar.

What complications can happen?

The healthcare team will try to reduce the risk of complications as much as possible.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Your risk may also depend on whether you have all or part of your thyroid gland or any lymph nodes removed. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Infection of the surgical site (wound).
• Blood clot in your leg (deep-vein thrombosis – DVT).
• Blood clot in your lung (pulmonary embolus), if a blood clot moves through your bloodstream to your lungs.
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Bleeding during or after the operation. Bleeding in your wound can be serious if it leads to swelling in your windpipe (trachea). You may need another operation to stop the bleeding and remove the blood clots.
• Change in your voice. Slight, temporary changes are common. In some cases the changes may be permanent.
• Aspiration problems. This can happen if one of the nerves in your neck that supply your voice box is damaged.
• Drop in calcium levels in your blood. You may need long-term calcium supplements. The risk is higher if you need to have your lymph glands removed.
• Thyroid hormone levels in your blood may drop, particularly if most of the thyroid has been removed. You may need replacement treatment with thyroxine tablets and your blood levels will be monitored for life. The risk of needing long-term thyroxine treatment is lower if only half of the thyroid is removed, and you have never had surgery to the other half.
• Breathing difficulties. You may need a procedure to place a breathing tube in your windpipe.

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home after 1 to 2 days.

You should be able to return to work and normal activities after about 2 weeks, depending on how much surgery you need and your type of work.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a full recovery and can return to normal activities.

The healthcare team will usually arrange for you to come back to the clinic within 4 weeks but you may have a telephone follow-up appointment. The tissue that your surgeon removed will have been examined under a microscope. Your surgeon will tell you the results and discuss with you any treatment or follow-up you need.

Summary

A thyroid lump can be caused by cancer. A thyroidectomy involves removing all or part of your thyroid gland. This gives you the best chance of being free of cancer, and helps your surgeon to decide if you need any further treatment.

IMPORTANT INFORMATION

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