What are three major life threatening complications postoperatively of a thyroidectomy?
OverviewLocation of thyroid.What is a thyroidectomy?A thyroidectomy is the surgical removal of all (total thyroidectomy) or part (partial thyroidectomy) of your thyroid gland — the butterfly-shaped organ in your neck. Show
Thyroidectomy is the main surgical treatment for thyroid cancer and is a treatment option for certain thyroid conditions, including:
Types of thyroid cancer include:
What is the thyroid?Your thyroid is a small, butterfly-shaped gland located at the front of your neck under your skin. It’s a part of your endocrine system and controls many of your body’s important functions by producing and releasing certain hormones, which are often referred to as thyroid hormone. Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, skin, muscles and other tissues. These signals tell your body what to do and when to do it. Your thyroid’s main job is to control the speed of your metabolism (metabolic rate), which is the process of how your body transforms the food you consume into energy. All of the cells in your body need energy to function. There are two main parts of your thyroid: the two halves (lobes) and the middle of the thyroid that connects the two lobes (thyroid isthmus). What are the types of thyroidectomies?There are two main categories of thyroidectomies: Total and partial. Types of partial thyroidectomies, which involve removal of part of your thyroid include:
A total or near-total thyroidectomy is the surgical removal of all or most of your thyroid tissue. The type of thyroidectomy you need depends on the reason for the surgery. For example, if you have a nodule on one side of your thyroid, you may need a hemithyroidectomy to remove the affected lobe. If you have a large goiter or a large cancerous tumor, you’ll likely need a total thyroidectomy. Together, you, your endocrinologist and your surgeon will determine the best surgery plan for you. When would I need a thyroidectomy surgery?Your healthcare provider may recommend thyroidectomy for any of the following reasons:
How common are thyroidectomy surgeries?Thyroidectomies are a common surgery. Surgeons perform more than 150,000 thyroidectomies in the United States each year. What questions should I ask my healthcare provider about a thyroidectomy?If your endocrinologist recommends thyroidectomy, it may be helpful to ask your endocrinologist and/or surgeon the following questions:
Procedure DetailsHow do I prepare for a thyroidectomy surgery?Your endocrinologist and surgeon will give you specific instructions to prepare for your thyroidectomy. Be sure to follow them. Depending on your reason for needing a thyroidectomy, in the weeks before your surgery:
At least one week before surgery:
You’ll need to fast (not eat or drink anything except water) for several hours before your surgery. Your provider will give you specific instructions. What happens during a thyroidectomy surgery?Before your surgery, an anesthesiologist will give you general anesthesia to relax your muscles, prevent pain and make you fall asleep. Your healthcare team will also place a breathing tube down your throat for the procedure. During a thyroidectomy, there are a few ways your surgeon can access your thyroid, including:
Depending on your situation, your surgeon will remove:
During surgery for a thyroid cancer diagnosis, your surgeon may sample lymph nodes around your thyroid gland. If found, a pathologist will check the lymph node sample during surgery for evidence of thyroid cancer. If they find cancerous cells, your surgeon may also remove nearby lymph nodes in your neck. Once your surgeon is done, they’ll close the incision with stitches (sutures). Surgery to remove your whole thyroid may take up to four hours. It may take less time if your surgeon removes only part of your thyroid. What can I expect after a thyroidectomy surgery?Once you have recovered from anesthesia and are fully awake, you’ll likely be able to have something light to eat and drink. Your throat may be sore due to the breathing tube your healthcare team placed during the surgery. You may also have a small tube (catheter) in your incision to help drain blood and other fluids that build up. Your surgeon will remove the drain one or two days after the surgery. Risks / BenefitsWhat are the risks or possible complications of a thyroidectomy?If a specially trained and experienced surgeon performs a thyroidectomy, it’s generally very safe. Complications are uncommon, but the most serious possible risks of thyroidectomy include:
While these complications are rare, they’re more likely to happen if:
If you’re concerned about possible complications of your surgery, talk to your surgeon. Recovery and OutlookWhat is the recovery time for a thyroidectomy?Many people who have a thyroidectomy, especially a hemithyroidectomy, are able to go home the same day of their surgery after a few hours of observation in the hospital. Some people have to stay in the hospital overnight and can leave the next morning. Before you go home, your provider will give you instructions on how to care for your incision and stitches and let you know what types of complications and symptoms you need to look out for. It should take about two to three weeks for you to fully recover. When can I go back to my normal activities after a thyroidectomy?You’ll likely be able to go back to your normal, light activities the first day after your thyroidectomy. Your surgeon will likely recommend that you limit more intense physical activities for a week or two. This is mainly to reduce the risk of a neck hematoma (blood clot) and breaking open your stitches. You should wait at least 10 days to two weeks before returning to vigorous sports and activities, such as swimming and heavy lifting. What are the side effects of having your thyroid removed?The main side effect of having your thyroid removed is a lack of thyroid hormone. After a near-total or total thyroidectomy , you’ll need to take daily thyroid hormone (levothyroxine) pills for the rest of your life to replace the lost thyroid hormone your thyroid naturally made. If you’ve had a hemi-thyroidectomy or thyroid lobectomy, there’s a 60% chance you won’t need to take thyroid medication unless you’re already on thyroid medication for low thyroid hormone levels (hypothyroidism) or blood tests reveal that your thyroid isn’t making enough hormones. When to Call the DoctorWhen should I call my healthcare provider after a thyroidectomy?If you’re experiencing any of the following symptoms or situations after your thyroidectomy, it’s important to call your healthcare provider:
A note from Cleveland Clinic It can be stressful to undergo surgery. Know that thyroidectomies are a common surgery and are generally safe if performed by a qualified and experienced surgeon. If you have any questions or concerns about your thyroidectomy, feel free to talk to your endocrinologist or surgeon. They’re available to help you. What is a major complication after thyroidectomy?However, serious post-thyroidectomy complications do occur, and they include recurrent laryngeal nerve injury, permanent hypoparathyroidism, postoperative bleeding, and hypocalcemia [7-8].
What are the hazardous effects of thyroidectomy?Potential major complications of thyroid surgery include bleeding, injury to the recurrent laryngeal nerve (see the first image below), hypoparathyroidism, hypothyroidism, thyrotoxic storm, injury to the superior laryngeal nerve (see the second image below), and infection.
What is the most important complication to monitor when caring for a patient after thyroidectomy?Hypocalcemia is the most frequent, symptomatic or asymptomatic, rebleeding with hematoma, laryngeal nerve injury, acute pain or infection as the most important. There is a series of care that favors the early detection of these and other things.
Which is a serious complication of hypocalcemia after thyroidectomy?Hypocalcemia remains a major post-operative complication of total thyroidectomy causing potentially severe symptoms and anxiety in affected patients and increasing hospitalization time.
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