What is thyroidectomy?
It is an operation to remove part or all of the thyroid gland under general anesthesia.
INDICATIONS:
1- The presence or suspicion of thyroid cancer is an absolute indication for surgery.
2-Large nodules:Although they do not carry a cancer risk, large nodules may cause pressure-related and cosmetic problems. In addition, since it may be possible to miss a small cancer focus within a large nodule by needle biopsy, surgery can be performed on nodules larger than 4 cm.
3-Hyperthyroidism: It occurs due to overwork of the entire gland or an active nodule. If the condition does not respond to medication and/or radioactive treatment, surgery may be performed.
What are the types of surgery: As with all surgical techniques, many name classifications have been made and these can be a bit confusing. The most understandable and simple classification that is most used today is as follows:
1-Total thyroidectomy: It is the removal of the entire thyroid gland (Right and left lobes, isthmus {midline} , pyramidal lobe {section extending upwards})
2-Near-total thyroidectomy: It is deliberately leaving 1-2 grams of tissue in the thyroid beds. The aim here is to prevent any damage to the nerve if it is very intertwined with the thyroid tissue. Since it is not possible for this much remaining tissue to be functional, the aim is only to protect the nerve.
3-Subtotal thyroidectomy: It is to leave more than 1-2 grams of tissue in the thyroid beds. It is not an accepted technique today and is preferred by less experienced surgeons. The remaining tissue here is more than in the second method, but it will still not be enough for normal hormone secretion. It should definitely not be applied in thyroid cancers, nor should it be preferred for benign diseases.
4-Total lobectomy: Removing the entire thyroid lobe on one side, leaving the other lobe untouched. This method involves removing the entire lobe where the nodule is located and waking the patient when there is a single nodule that is suspicious for cancer. Cancer will definitely be differentiated in the pathological examination to be performed after the surgery. If the patient does not have cancer, he/she will not need additional treatment. It will not be necessary and most likely, he will continue his life without taking external hormones, thanks to the functioning of the opposite lobe.
5-Complementary thyroidectomy: In the above-mentioned table, that is, in the pathology examination after the removal of a single lobe. If cancer occurs, the opposite lobe is removed with a second surgery and a total thyroidectomy is performed (even if the opposite lobe is normal).
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