What is Thyroidectomy?

Thyroidectomy is a surgical procedure planned by considering the size of the thyroid gland and whether lymph node dissection will be performed. In some cases, surgical intervention may be required for the treatment of thyroid gland cancer or other diseases. In such situations, thyroidectomy comes into play. Today, this surgery is performed with much more advanced techniques. To minimize the risk of complications, the operation should be carried out by highly experienced surgeons. We will also explain whether surgery is always necessary in thyroid diseases and how much of the thyroid gland needs to be removed. But first, let’s examine this operation in more detail.

How Is Thyroidectomy Surgery Performed?

In thyroidectomy surgery, an incision is made in the front part of the neck. The length of this incision can vary between 4 cm and 5 cm. The operation is performed under general anesthesia, so it is not possible for the patient to feel any pain or discomfort during the procedure, including incision and suturing. Through the incision, the muscles located just beneath the skin are reached. These muscles are opened to access the thyroid gland. The thyroid gland resembles a butterfly, meaning it has two lobes.

During surgery, one lobe is separated first, followed by the other. These lobes must be separated from the trachea. Then, to avoid damaging the nerves that pass behind the thyroid gland and connect to the vocal cords, the parathyroid glands must be carefully preserved and slightly mobilized. These glands are located behind the thyroid and are about the size of a grain of rice. After gently repositioning the parathyroid glands, the thyroid gland can be operated on. As planned before surgery, part or all of the thyroid gland is removed through the incision. The incision is then sutured, completing the operation. In some patients, additional procedures may also be required during surgery.

Is Surgery Necessary?

Not every patient with a thyroid condition requires surgery. After making a diagnosis, your doctor will evaluate the condition in detail. In some cases, non-surgical treatment methods may be sufficient. Surgery is only necessary in certain situations, and your doctor will provide the necessary explanations.

How Much of My Thyroid Gland Needs to Be Removed?

The amount of thyroid tissue removed is not the same for every patient. This decision must be made by the surgeon performing the operation. In patients with papillary or follicular thyroid cancer, total or near-total thyroidectomy is usually preferred. After such procedures, radioactive iodine therapy is often administered to increase treatment success. In patients with tumors larger than 1.5 cm or aggressive cancers, it may be necessary to remove potential lymph node metastases. This also applies to patients with medullary thyroid cancer, requiring a more extensive lymph node dissection.

If patients have a unilateral overactive nodule along with symptoms such as pressure, hoarseness, difficulty swallowing, or shortness of breath, lobectomy may be preferred, provided the nodule is benign. Patients with Graves’ disease or large multinodular goiter generally require total or near-total thyroidectomy. As seen, the extent of thyroid removal is closely related to the nature of the disease. Both the condition and the patient’s overall health are evaluated together to determine the most appropriate surgical method.

What Is the Postoperative Process Like?

Patients often wonder what to expect after surgery. They may want to know whether they can resume their normal activities. A short recovery period is required, during which rest is important. Mild pain after surgery is normal, and your doctor may prescribe painkillers to manage it.

Once the effects of surgery subside, patients can resume their preoperative activities. However, some patients may need lifelong medication. Taking medication regularly is essential for maintaining good health. In many cases, hypothyroidism may develop after surgery, requiring thyroid hormone therapy. This is particularly common after thyroid cancer surgery. In some patients, radioactive iodine therapy is also administered. If this treatment is planned, thyroid hormone replacement therapy may be postponed for a few weeks.

What Is Near-Total Thyroidectomy?

Thyroidectomy can be performed using different techniques. These include:

• Unilateral Thyroidectomy (Lobectomy + Isthmectomy)

This is a commonly performed and minimally invasive thyroid surgery technique. In unilateral thyroidectomy, certain risks are lower or may not occur at all. However, it is generally preferred for benign thyroid tumors. In cases of malignant tumors, different techniques are required. After this procedure, the remaining thyroid tissue usually produces sufficient hormones, so medication may not be necessary.

• Total Thyroidectomy

Total thyroidectomy is used in conditions such as multinodular goiter and thyroid cancer. In this procedure, the entire thyroid gland is removed. It is a necessary treatment in such cases, and patients must take lifelong medication afterward.

• Total Thyroidectomy + Lymph Node Dissection

This method involves removing central or lateral cervical lymph nodes along with the thyroid gland. It is required in certain stages of thyroid cancer and in some rare cancer subtypes.

Lobectomy refers to the surgical removal of approximately half of the thyroid gland. In subtotal thyroidectomy, a small amount of thyroid tissue is left in both lobes. The remaining tissue is removed during the procedure.

How Long Does Thyroidectomy Surgery Take?

The surgical procedure may vary from patient to patient, so the duration can also differ. Generally, the operation takes between 1 and 2 hours. However, depending on the patient’s condition and the required intervention, it may be shorter or longer. After surgery, patients are usually advised to rest for a few days.