Thyroid Surgery

Thyroid Cancer Surgery

Thyroid cancer has traditionally been associated with higher rates of complication, including recurrent laryngeal nerve injury, as compared with surgery for benign thyroid conditions. With expertise in head and neck surgical techniques and extensive knowledge of the anatomy of the recurrent laryngeal nerve, parathyroid glands, and surrounding lymph nodes, our surgeons are well prepared for these challenging cases.

Our extensive experience and use of recurrent laryngeal nerve monitoring has allowed us to perform these complex procedures with a low risk of complications. Close pre- and postoperative communication and collaboration with the patient’s medical endocrinologist allows for coordinated care.

For known thyroid cancer, typically the surgery involves removing the entire thyroid gland and sometimes also removing the lymph nodes. Because of the extent of surgery, it can take anywhere from 2 hours for routine cases to 4 hours for more complex cases, with an overnight hospital stay needed. Any pain after the surgery is limited and usually alleviated with prescription and over-the-counter mild pain medication. Patients can generally speak, eat, and breathe normally right after surgery.

Following surgery, the physician will review the pathologists report and make further recommendations in conjunction with the medical endocrinologist. This may include treatment with radioactive iodine therapy under the direction of the endocrinologist. This is a limited therapy with little to no post-treatment side effects.

Standard external beam radiation therapy and chemotherapy are rarely needed and generally, only in cases of more aggressive cancers. Our physicians are well versed—not only with the surgical treatment of thyroid cancer but also in post-surgical treatment.

We will help guide you through this process in order to achieve the most favorable outcome that is possible and involve other specialists as needed. Although the prognosis for most thyroid cancers is extremely favorable, long-term follow up is needed with thyroid cancer with both your surgeon and your endocrinologist.

Thyroid Nodule Surgery

There is no medical treatment for thyroid nodules. If a decision is made that the thyroid nodule needs to be removed, surgical treatment is recommended. Typically, surgery is performed through a small incision at the base of the neck and involves removal of one lobe of the thyroid or the entire thyroid gland. The surgery usually takes 2 to 3 hours, and most patients are watched carefully in the hospital overnight. The pain is often minimal, and most patients take 4 to 7 days off from work to recuperate.

Some patients will need to take thyroid replacement medication long-term after surgery. This medication promotes normal thyroid function and normal metabolism after surgery so that patients are able to return to normal. Additionally, if there is evidence of cancer, some patients may require the administration of postoperative radioactive iodine treatment.

Your surgeon will communicate and make a decision with you after surgery regarding these potential postoperative interventions.

An important risk to consider with any type of thyroid surgery is the potential loss of voice, swallowing, and, sometimes, breathing function. Surgeon experience and measures taken to preserve the nerves in this complex area are imperative to a good outcome.

These measures include fiber-optic preoperative laryngeal exam, voice analysis, and intraoperative nerve monitoring. Another risk of surgery is a potential compromise of parathyroid function. The parathyroid glands are very small glands that sit at the periphery of the thyroid gland and should be handled carefully during thyroid surgery, as they have an important role in calcium metabolism. Our surgeons are experts on parathyroid anatomy and preservation. Occasionally patients experience a temporary loss of parathyroid function from surgical manipulation and may require short-term supplementation with calcium pills until the function of these glands recovers.