Thyroid Surgery

The thyroid gland is a butterfly-shaped organ located in the front of the neck. It regulates body metabolism with the hormones it secretes. When it gets sick, the amount of hormones it secretes become irregular, it grows too much, or cancer may develop. In cases where drug treatment cannot be administered, surgery is required.

Thyroid surgery is the partial or complete removal of the thyroid. The amount of tissue to be removed is a decision that the endocrinologist, the patient and the general surgeon must make in consensus, depending on the type, extent and size of the disease.

Situations requiring thyroid surgery:

• Thyroid cancers

• Presence of nodules suspicious for cancer

• Situations in which the thyroid is overactive (nodular hyperthyroidism - multinodular hyperthyroidism (Basedow)

• The thyroid becomes too large and puts pressure on the throat, creating difficulty in breathing and swallowing

• The thyroid becomes too large and puts pressure on the throat causing cosmetic problems

 

Thyroid surgeries

There are different surgical techniques, the most frequently applied ones are

• Conventional open technique is the removal of thyroid tissue through a horizontal incision made on the front of the neck, it is applied for all types of thyroid diseases, regardless of size and which thyroid disease. It is a technique that can be applied no matter what. It is the only method that can be applied if the patient has previously had thyroid surgery.

• Endoscopic surgery is performed through a small incision in the front of the neck, and is a more suitable surgery for small thyroid nodules.

• Oral (TOETVA) surgery is a surgery performed with the help of special tools through 3 small incisions made on the inner surface of the lower lip. Its use has not become widespread in Basedow's disease, large thyroid tissue and thyroid cancers. It is a surgery preferred for cosmetic reasons. There is no incision in the neck, but lip movements may be impaired due to nerve injury related to the lip. Since it is entered through the mouth, the risk of infection is higher.

In thyroid surgeries, thyroid tissue or It is removed partially (partial thyroidectomy) or completely (total thyroidectomy).

In Basedow's disease and cancers In most cases, thyroid tissue must be completely removed.

In Basedow's disease, there may be exophthalmos, the eyes are displaced outwards, the eyes appear enlarged, the eyelids do not close completely. When the thyroid tissue is completely removed, the phenomenon we call exophthalmos may completely regress.

In some types of thyroid cancer or if the cancerous tissue is large, a surgery called total thyroidectomy is performed, that is, the entire thyroid tissue is removed. The purpose of total thyroidectomy is to prevent recurrence of the disease.

Total thyroidectomy also provides convenience in terms of monitoring cancer, because Thyroglobulin (Tg) is produced only from thyroid tissue, and thyroid cancer cells also produce this substance. When all thyroid tissue and cancerous tissues are removed, the blood value of this substance drops below 0.1ng/ml. Increasing these values ​​after surgery may indicate recurrence of the disease. Thyroglobulin is a type of tumor marker.

 

Thyroid surgery risks (complications)

When performed carefully, it is not a surgery with complications very often. However, it is necessary to mention its potential complications.

• Hoarseness, hoarseness is a complication due to nerve damage, the "nervus recurrens" nerve is very close to the thyroid tissue, surgery During the procedure, it is necessary to find the nerve and protect it. There are systems for nerve monitoring. It is a simple procedure. An experienced surgeon can find the nerve without monitoring systems. Finding the nerve should be routine practice in every surgery.

• Bleeding is a rare complication, bloody discharge in the form of oozing is clearly in the form of fresh blood.

• Decrease in parathyroid hormone (hypoparathyroidism) There are 4 parathyroid glands on the back side of the thyroid gland, which look like they are attached to the thyroid tissue. These glands control the level of calcium in the blood with the hormone they secrete. Damage or accidental removal of these glands during surgery causes the calcium level in the blood to drop. When the calcium level in the blood decreases, tingling, numbness and cramps occur in the hands and face. Keeping calcium levels normal with medications It is necessary.

• Infection: It is a rare complication, because the blood supply of this area is very good and the defense mechanisms are strong.

 

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