The Unit of thyroid surgery and other endocrine glands of barnaclínic+ offers you the possibility to make an appointment with our center over the Internet. Once you have made your request, we will contact you, trying to respect your preferences.
Thyroid pathologies
The Thyroid may develop a disorder. Although the majority of these dysfunctions can be treated medically, on occasions it is necessary to operate to remove the thyroid. This is the case with some thyroid nodules, large multinodular goiters, hyperthyroidism (excessive function of the gland) and thyroid cancer.
Some situations in which the doctor may recommend thyroid surgery are:
· A small tumour (nodule or cyst) in the thyroid
· An overactive and dangerous thyroid gland (thyrotoxicosis)
· Thyroid cancer
· Benign tumours in the thyroid gland which are causing detrimental symptoms
· Inflammation of the thyroid that hinders breathing and/or swallowing
Thyroid Surgery
Operations on the thyroid gland are usually performed under general anesthesia.
Surgeries and Procedures
Benign tumours
Hemithyroidectomy + isthmectomy: Complete removal of the thyroid lobe affected including the central part of the thyroid (isthmus).
Total thyroidectomy: Complete removal of the gland (both lobes and the central part), this application prevents relapses on remnants and deters the persistence of hidden carcinomas.
Subtotal thyroidectomy: Almost complete removal of the gland (lobectomy total + contralateral subtotal lobectomy) which may be appropriate for patients of advanced age in which the risk of reoccurrence is minimum), as long as the tumours are not malignant.
Malignant tumours
The extent of the surgery will depend on the type of malignant tumour the patient has. The most common is differentiated thyroid carcinoma (papillary variant 85%, follicular variant 15%), followed by thyroid medular carcinoma.
The total thyroidectomy (TT) is the preferred initial treatment for most patients. If the procedure carries a very low risk (<10mm, without metastases and with a favourable histology), there is some divergence on the extent of the thyroidectomy, although it is clear that the minimum surgery performed must be a lobectomy with a total with isthmectomy and resection of the pyramid.
There is some controversy about whether to perform a systematic lymphadenectomy of the central neck compartment (VI), since this is the first step of lymphatic drainage and is affected macro- or microscopically in 60% of cases.
Malignant tumours with nodal involvement
The total thyroidectomy (TT) is the preferred initial treatment for most patients.
There is however a consensus of opinion on carrying out a modified radical side lymphadenectomy (compartments II-V), both for Papillary Carcinoma as for Follicular Carcinoma, in all patients with palpable adenopathies or those detectable by ultrasound when the puncture-cytology confirm that they are metastatic.
Advice and indications for surgery
Before the operation
The patient should carry on with their life with complete normality, whilst trying not to get overly tired.
In the 6 hours prior to the surgical procedures they cannot ingest solid food or liquids.
After the operation
Pain
The patient must take analgesics and light anti-inflammatory medication for one week. Doing so, we can keep pain in the area of the wound to a minimum. In the majority of cases, the patient will only manifest some neck discomfort.
Prevention of Hypocalcemia
The patient should take calcium for a few days. With this we will enable the parathyroid glands to rest and they will have a better chance of recuperation from the aggression produced to the thyroid cell during the operation to remove the thyroid.
Hormone replacement
Depending on the type of operation performed, through analysis the doctors will establish whether the patient will need hormone replacement with thyroid hormones, in cases where the patient has had a total thyroidectomy, the medication will begin the day after the procedure. Initially, the patient will be administered an orientated dose depending on their weight, which can be modified depending on their metabolic activity.
Weight Management
The alteration in the weight (gain) is a direct consequence of the deficit of the thyroid hormones and the inactivity caused by the postoperative period. Our aim will be to maintain the patient's hormone levels to a correct level despite the surgical intervention.
Common transitional complaints
· Change in the quality of the voice.
· Some dysphonia
· Inability to scream
· Mild sore throat when swallowing saliva
· Some difficulty in swallowing
· Sensation of mucus in the throat
· A somewhat irritant cough
· Itching in the wound area
When you leave the Hospital
During the first week the patient should partially rest and avoid both physical effort as well as straining the voice.
From the second week onwards the patient will be able to return to to their everyday activities in a progressive manner.
In most cases, the patient will be able to return to their normal activities from the third week after the operation.
Protect the wound with a scarf or high neck until the surgeon instructs you otherwise.
Thyroid expert
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