Surgery can be used to remove a large goiter or a hyperfunctioning nodule within the gland. Surgery is necessary when there is a possibility of thyroid cancer. If the thyroid gland is removed entirely, the individual will need to take synthetic thyroid hormone for life. Thyroid surgery can also be used in Graves' Disease (subtotal thyroidectomy) and was the treatment of choice prior to RAI therapy and anti-thyroid medications. It is not used much now.
An Endocrine Surgeon is the specialist who performs a thyroidectomy. A total thyroidectomy is recommended for thyroid cancer, restriction caused by an enlarged thyroid gland pressing on the windpipe, oesophagus or nerves. Surgery is also performed when a patient has a suspicious nodule(s), which could be malignant or an uncontrollable overactive thyroid gland. This procedure is done as an inpatient in hospital and you are usually in hospital for two days. You will have a small scar in the lower part of the centre of your neck, just above the sternum or breastbone.
There are two types of thyroidectomy:
Total Thyroidectomy – The total removal of the thyroid gland
Hemi Thyroidectomy – The partial (one lobe) removal of the thyroid gland.
After surgery you will usually be prescribed thyroid replacement hormone, thyroxine to take each day. In some cases where only a single lobe is removed, you may not need to take thyroxine. However, the LEF recommend regular thyroid function pathology monitoring by your General Practitioner or Endocrinologist of your thyroid hormone levels is important.