Thyroidectomy: indications, methods, consequences
The thyroid gland regulates a large number of important processes in the organs and tissues of the human body - therefore, the well-being of the entire body depends on its condition. So, the question of what life will be like after a thyroidectomy (that is, complete removal of the gland) worries every patient who is waiting for the removal of this organ by a surgical method.
There are two absolute indications for thyroidectomy:
- malignant impression of the organ (cancer, sarcoma, etc.);
- multinodular toxic goiter (enlargement) of the thyroid gland, when no healthy tissue is observed at all, and therefore it makes no sense to leave the gland completely affected by the pathological process.
The thyroid gland produces hormones that are directly responsible for metabolism. It:
- thyroxine (regulates the main metabolism in the body);
- triiodothyronine (like thyroxine, is responsible for the main metabolism in organs and tissues);
- calcitonin (keeps calcium exchange and bone tissue development under control, this factor depends, for example, on how successfully you will grow bone fragments after fractures).
Accordingly, the mentioned hormones are not produced in the body after the removal of the thyroid gland. Because of this, the basic metabolism, calcium exchange and proper development of bone structures are disturbed. Therefore, surgeons try, if possible, to practice the removal of a part of the thyroid gland in order to avoid the negative consequences that occur as a result of the complete removal of the organ.
Operation to remove the thyroid gland
The development of the latest methods of treatment allows to spare the thyroid gland - it is removed completely only in those cases when it is completely compromised. If there is an impression of the gland in the form of cells (nodules), then they try to rid the patient of them without touching the unchanged tissues. For example, thyroid nodules are removed with a laser.
Thyroidectomy is performed under general anesthesia. But some surgeons prefer to remove the thyroid gland under local anesthesia to avoid some extremely undesirable complications.
The return nerve passes symmetrically near the thyroid gland on both sides, damage to which causes the voice to disappear. Under local anesthesia, the patient can answer the questions of the operating team, which allows to control whether the recurrent nerve was not affected during the operation. But the skill of surgeons, which is growing, and the latest methods of surgical intervention leave no chance for damage to the recurrent nerve during surgery under general anesthesia.
If no force majeure was observed during the operation (for example, pronounced bleeding), then the postoperative period passes without any specific features. Sore throat, swelling of soft tissues, pulling pain on the back of the neck may be observed, but these are common phenomena observed after thyroidectomy.
Often, patients worry about the aesthetic side and ask whether the seam will be noticeable after surgery to remove the thyroid gland. Women who do not like to wear high collars are especially worried. Correctly performed incisions of the skin and adjacent tissues, the use of fine surgical needles and threads, careful application of sutures, the presence of natural skin folds on the neck contribute to the fact that the scar after thyroidectomy is noticeable only if you look very carefully at it, knowing about thyroidectomy in the past.
Consequences of complete removal of the thyroid gland in women appear much more often than in men. Thyroidectomy in the representatives of the beautiful half of humanity leads to the fact that they begin to develop diseases of the reproductive system one after another with all the consequences.
Alternatives to thyroidectomy
In order to preserve the body's natural source of thyroxine, triiodothyronine, and calcitonin, surgeons perform thyroidectomy only in those cases when there is absolutely no healthy tissue left in the gland. If no oncological process is detected, but a goitre (enlargement of the thyroid gland) is diagnosed, then local removal of the goitre of the thyroid gland is practiced.
If benign tissue changes in the form of nodules are detected in the organ (this is confirmed by a biopsy), they are carefully removed during surgical treatment. At the same time, they try to spare the unchanged tissues as much as possible, which are still able to serve for the production of thyroid hormones.
Replacement therapy after thyroidectomy
Since thyroid hormones are no longer produced after its complete removal, replacement therapy is necessary. That is, after removal of the thyroid gland, triiodothyronine and thyroxine must be continuously supplied from the outside in the form of pharmaceutical preparations. Otherwise, the body will lose control over metabolic processes, which was carried out thanks to these hormones.
Of course, thyroid hormone precursors are not produced either. Thus, thyroglobulin after the removal of the thyroid gland is not detected in the blood at all, since it is produced exclusively by the "factory" of the thyroid gland.
Also, after the total removal of the thyroid gland, it is necessary to monitor the level of thyroid-stimulating hormone (TSH) in the blood. This is a hormone that normally regulates the activity of the thyroid gland, and it is produced in the pituitary gland (a small structure located in the brain). In the absence of a thyroid gland (in particular, after a thyroidectomy), TSH continues to be produced if the pituitary gland is working properly. The TSH level after surgery signals the effectiveness of replacement therapy. After thyroidectomy, if the body does not receive drugs that replace triiodothyronine or thyroxine, then according to the principle of feedback, the level of TSH will increase to stimulate the production of thyroid hormones.
Provided a reasonable approach to life after thyroidectomy, its level and quality will not change if you choose a competent doctor, and he will determine the tactics and strategy of medical management of you as a patient.
You can learn more about all the nuances of thyroidectomy by visiting the website of our medical center Dobrobut.com. Including, you will receive reliable information about the cost of thyroidectomy.
Related services:
ultrasound of the thyroid gland
Oncologist consultation
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