Thyroid

Thyroid surgery is used to treat thyroid nodules, thyroid cancer, and hyperthyroidism. During this procedure, part or all of the thyroid gland is removed. The thyroid gland is a butterfly-shaped gland located at the front of the neck.

During surgery, an incision is made in the skin. The muscle and other tissues are pulled aside to expose the thyroid gland.

Why Is Surgery Needed?

Surgery is used to treat thyroid problems if:

  • Thyroid cancer is present or is suspected.
  • A noncancerous (benign) nodule is large enough to cause problems with breathing or swallowing.
  • A fluid-filled (cystic) nodule returns after being drained once or twice.
  • Hyperthyroidism cannot be treated with medicines or radioactive iodine.

Surgery is rarely used to treat hyperthyroidism. It may be used if the thyroid gland is so big that it makes swallowing or breathing difficult or thyroid cancer has been diagnosed or is suspected. Surgery also may be done if you are pregnant or cannot tolerate antithyroid medicines.
You may have all or part of your thyroid gland removed, depending on the reason for the surgery.

  • Total thyroidectomy - Your surgeon will remove the entire gland and the lymph nodes surrounding the gland. Both sections (lobes) of the thyroid gland are usually removed. Additional treatments with thyroid-stimulating hormone (TSH) suppression and radioactive iodine work best when as much of the thyroid is removed as possible.
  • Thyroid lobectomy with or without an isthmectomy - If your thyroid nodules are located in one lobe, your surgeon will remove only that lobe (lobectomy). With an isthmectomy, the narrow band of tissue (isthmus) that connects the two lobes also is removed. After the surgery, your nodule will be examined under a microscope to see whether there are any cancer cells. If there are cancer cells, your surgeon will perform a completion thyroidectomy.
  • Subtotal (near-total) thyroidectomy - Your surgeon will remove one complete lobe, the isthmus, and part of the other lobe. This is used for hyperthyroidism caused by Graves’ disease.

How Well It Works

Success of a thyroidectomy to remove thyroid cancer depends on the type of cancer and whether it has spread (metastasized) to other parts of the body. You may need follow-up treatment to help prevent the cancer from returning or to treat cancer that has spread.

What To Expect After Surgery

Many people leave the same day of surgery. How much time you spend in the hospital and how fast you recover depend on your age and general health, the extent of the surgery, and whether cancer is present.