thyroidectomy

Thyroidectomy is a surgical procedure in which all or part of the thyroid gland is removed. It is performed for diseases of the thyroid, including benign conditions such as goiter or Graves disease, and for thyroid cancer. The operation may relieve compressive symptoms, control hyperthyroidism, or ensure complete removal of malignant tissue.

Indications vary and can include a large symptomatic goiter, toxic multinodular goiter, persistent hyperthyroidism despite medical therapy, suspicion of thyroid cancer, or confirmed cancer with regional spread. The choice of procedure depends on the disease, the size and location of the thyroid nodule, and the presence of cancer in one or both lobes.

Types of thyroidectomy include hemithyroidectomy (unilateral lobectomy with removal of the isthmus), subtotal or near-total thyroidectomy (most but not all thyroid tissue removed), and total thyroidectomy (complete removal of both lobes). In cancer, central neck or lateral neck dissection may accompany thyroidectomy if lymph node involvement is suspected or confirmed.

Procedure and recovery: The operation is performed under general anesthesia through an incision in the lower front of the neck. The surgeon identifies and preserves the parathyroid glands and the recurrent laryngeal nerves while removing the targeted thyroid tissue. A drain may be used in some cases. Hospital stay typically ranges from one to three days. Postoperative care includes monitoring for voice changes, calcium levels, and wound healing. Lifelong thyroid hormone replacement is commonly required after total thyroidectomy; after partial resections, replacement is less predictable and depends on remaining thyroid function. Follow-up involves thyroid function tests and, in cancer, tumor markers or imaging as appropriate.

Complications may include temporary or permanent hoarseness from nerve injury, hypocalcemia from parathyroid disruption, bleeding, infection, or hematoma. Rare complications include airway obstruction and injury to surrounding structures. Alternatives to surgery include antithyroid medications, radioactive iodine therapy, or observation, depending on the condition.