general-surgery

Thyroid Surgery

Thyroid surgery is performed for various reasons and often in cases where there is a thyroid lump or enlargement. A thyroid lump requires further investigation which often involves an ultrasound, fine needle aspiration and sometimes, a diagnostic excision. A thyroid lump may occur either as a single lump or in the setting of a multinodular goitre. Some of the indications for thyroid surgery include thyroid lump or enlargement, airway compromise, hyperactive thyroid and thyroid cancer.

The thyroid is made up of 2 lobes bridged by the isthmus and sits on the trachea (windpipe). Thyroid surgery may involve removal of 1 lobe (thyroid lobectomy or hemithyroidectomy) or removal of the whole gland (total thyroidectomy). This is performed under general anaesthesia through a skin crease incision near the base of the neck. Meticulous care is taken to identify and preserve the nerves that supply the vocal cord. The potential complication includes haemorrhage, hoarseness and low calcium (due to injury/removal of the parathyroid glands). The rate of complication is low and the patient is often discharged from hospital within 1 – 2 days after surgery. A waterproof dressing is used and the patient is able to eat and drink as tolerated after surgery. The waterproof dressing is often removed after 5 – 7 days. Neck wounds usually heal up well with a fine scar. If a total thyroidectomy is performed, the patient will be started on long term thyroxine tablets after discharge from hospital. A blood test is performed after 3 weeks to ensure that there is adequate thyroxine replacement.

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