About Your Thyroid Surgery
Before the Operation
clinic visit will include:
- A History and Physical (H & P) Examination: It is important to know your full health history and any and all of the medicines you take. Depending on your other medical problems, you may need to be seen by another specialist before your operation.
- Bloodwork and Tests: According to your age, medical condition, and the type of surgery planned, you may be asked to have an EKG (heart tracing), chest x-ray, or blood work before your surgery.
- Instructions for You and Your Family: We will explain what to expect on the day of surgery and answer any questions that you may have, including:
- Where to park
- What to bring
- When and where to arrive
We will also give you written information with maps and phone numbers. A doctor will explain the surgery and you will be asked to sign a Consent to Surgery form.
Anesthesia Evaluation: The anesthesiologist will see you on the morning of surgery if you are generally in good health. If you have any serious medical conditions, then you will also be seen by an anesthesiologist when you are in the Preoperative Clinic. Your record is then reviewed and the type of anesthesia is planned in advance.
How Long Will I Be in the Operating Room?
You will be in the operating room for about one to three hours with at least another 1 - 2 hours in the recovery room afterwards.
After Your Operation
Patient Discharge Instructions (pdf)
Risks of Thyroid Surgery
General Risks of Any Operation
Modern surgery is quite safe, but always entails some risk. Surgical complications are more likely in the elderly or in people with serious medical illnesses. Please inform your surgeon if you have previously had any of the following problems or believe you may be prone to them.
General risks of undergoing an operation include:
- Heart and circulation problems such as heart attack or blood clot formation. Clots which form in the legs can move to the lungs and cause life-threatening problems. Blood clots or debris can similarly cause a stroke.
- Wound infections are not common, but may be more likely in people with diabetes or steroid therapy, or who have had radiation treatment.
- Chest infections such as bronchitis or pneumonia can develop after a general anesthetic.
- A keloid may form within the surgical scar. A keloid is an overgrowth of scar tissue which may be raised, tender, pink, and irregularly shaped. Should this occur, treatment is available to improve the appearance of the scar.
Specific Risks of Thyroid or Parathyroid Surgery
Overall, there is little risk of complication from thyroid or parathyroid surgery. However, these operations can be very challenging due to the variable anatomy, small nerves, and other important structures in the region. Therefore, they are best performed by experienced specialist Endocrine Surgeons. Your surgeon will discuss the possible risks with you at the time of your initial visit and/or history and physical exam.
Some specific risks of surgery include, but may not be limited to:
- Bleeding from a vessel divided at the time of surgery may occur even early after the operation. This may cause difficulty breathing due to the pressure it creates under the incision. Transfusion is rarely necessary but a second operation may be required. This is not common, but may be life-threatening.
- Many patients develop hoarseness after surgery. In very few does it last more than a few days. Injury to the recurrent laryngeal nerve may occur during surgery, causing a more permanent hoarseness. These nerves control the vocal cords and are very delicate. Of every 100 patients having thyroid surgery, fewer than 1 or 2 will have a permanent injury to this nerve. Patients with thyroid cancer, very large goiters, or a history of previous neck surgery are at more risk of nerve injury because of the increased difficulty of the surgery. If related to this nerve dysfunction, voice changes may often be improved with speech therapy or corrective surgery. Even if the nerve function is normal, up to 5 - 10% of people may feel that their voice is slightly different after the operation. If you are a singer or a public speaker, you should discuss this further with your surgeon.
- If your calcium level falls after the operation, you will be given calcium supplements, either by IV or by mouth. About 15% of thyroidectomy patients and 25% of parathyroidectomy patients may require calcium supplements for a few days or weeks. You may even be prescribed calcium supplements before upon your discharge to prevent symptoms from a temporarily low blood calcium level. Of every 100 patients having a total thyroidectomy, only 1 or 2 will need to continue taking calcium supplements beyond 6 months following operation.
- If you have a total thyroidectomy, you will need to take thyroid hormone medication for the rest of your life. If you have only half of your thyroid removed, we may recommend you take this medication on a temporary or permanent basis. This will be determined in the weeks following your operation. Blood tests will determine if your dose of hormone replacement is optimal. Once the levels are correct, blood tests once per year are routine int the event that your requirements may change.