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Thyroid Surgery

Thyroid surgery is a method used for the treatment of disorders that occur in the thyroid gland. Depending on the condition of the disease, the entire gland or a part of it can be removed during the surgery.

The thyroid gland is of great importance for metabolism. It is located in the neck region and resembles a shield. It secretes very important hormones such as T3 and T4. The levels of these hormones should be within a certain range.

Otherwise, various health problems can occur. Therefore, thyroid diseases need to be treated quickly.

What is Thyroid Surgery?

Thyroid surgery is the name given to the surgical intervention performed depending on the disorder that occurs in this gland. This surgery can be performed for different reasons. However, all of them are referred to as thyroid surgery. The symptoms of thyroid also vary depending on the disorder.

When we say thyroid, different diseases may come to mind. However, it would not be wrong to say that the terms goiter and nodule stand out in these diseases.

What is Goiter?

Goiter is the name given to the enlargement of the thyroid gland due to various reasons. The root of this word is the word “guttur,” which means swelling. This disease can occur as the enlargement of the entire thyroid gland. In such a case, the disease is called diffuse goiter, while the enlargement that occurs due to nodules is called nodular goiter.

Symptoms of Goiter

Goiter is a disease that has different effects on each individual, depending on the underlying causes. The reason for this is actually the underlying causes of goiter. Sometimes, this condition occurs due to Graves’ disease, and sometimes it can occur due to exposure of the neck area to radiation. Therefore, the symptoms vary. However, the symptoms of goiter can generally be listed as follows:

  • Swelling in the neck area
  • Difficulty in breathing and swallowing
  • Cough
  • Getting fat
  • Hair loss
  • Constipation

The symptoms listed here are not seen in every thyroid patient. In some patients, there may not even be the slightest symptom.

What is a Nodule?

Nodules are masses that form within the thyroid gland due to various reasons. These masses are generally benign. No treatment is necessary for benign nodules.

However, about 10% of nodules are malignant. In such cases, the disease is defined as thyroid cancer.

Nodules are small masses and are often not noticeable from the outside. However, some nodules can reach a diameter of 2 cm, which can be easily noticed even with the naked eye.

How is the Decision Made for Thyroid Surgery?

The decision of whether to use surgical or medical methods for thyroid treatment is made after a series of tests. The most important factor in making this decision, especially in cases where a nodule is detected, is the biopsy result.

Biopsy is the pathological examination of a sample taken with a special aspiration needle. This determines whether the nodule is benign or malignant.

If a nodule is benign, surgery is not necessary. If benign nodules affect the functioning of the thyroid, drug therapy is evaluated as an option.

However, if a malignant nodule is detected, surgery is required. This is because a malignant nodule indicates thyroid cancer. Symptoms of thyroid cancer do not generally differ from those of other thyroid diseases.

The decision for surgery is made by the surgeon based on the tests and examinations performed on the patient. At this stage, patients are informed in detail about the effects and risks of surgery.

Preparations for surgery begin only if the patients consent to it. Surgery is not performed without the patient’s consent.

How is Thyroid Surgery Performed?

Thyroid surgery is performed under general anesthesia. Patients do not feel any pain due to the general anesthesia. A 4-5 cm incision is made in the neck after anesthesia.

Then, the thin muscles under the skin are opened to reach the thyroid gland. Extra care should be taken not to damage the vocal cords and parathyroid glands during this process. A special device is used for the vocal cords, and the location of the vocal cords is clearly determined.

Thus, they are prevented from being damaged during the operation.

Depending on the location, size, and number of nodules in the thyroid gland, part or all of the gland may be removed. For example, if there is a nodule on one side of the gland, which has a double-winged structure, only that part is removed, while the other part is left.

However, if there are multiple nodules on both sides, the entire gland is removed.
Thyroid surgery is performed for cancer or non-cancerous reasons. At this point, there are some surgical operations performed for treatment purposes. These can be listed as follows:

  • Lobectomy (removal of half of the thyroid gland)
  • Subtotal thyroidectomy (removal of the rest, leaving some thyroid tissue in both lobes)
  • Near total thyroidectomy (removal of the gland leaving less than one gram of tissue in one of the lobes)
  • Total thyroidectomy (removal of the entire gland)

Which of these options to apply should be decided by the surgeon based on the patient’s condition and the location and number of nodules.

Why Not Just Get Nodules?

In thyroid surgeries, not only the nodules but also the tissues they come into contact with are removed. In fact, it is much easier for the surgeon to remove only the nodule and takes much less time.

However, while performing this surgery, it is aimed not only to get rid of the nodules, but also to eliminate the possibility of recurrence.
As it is known, cancer cells can be found not only in the mass but also in neighboring cells.

Therefore, while performing thyroid surgeries, the tissues with which the nodule is in contact with the nodule are also taken.

What Are the Risks of Thyroid Surgery?

Thyroid surgeries, like other surgical procedures, have significant risks. These risks can be broadly listed as follows:

  • Infection
  • Bleeding
  • Bruising
  • Swelling
  • Pain
  • Embolism

In addition to the risks that apply to all surgeries, there are also specific risks associated with thyroid surgeries. Hoarseness of voice is one of the main risks, as the vocal cords are located very close to the surgical site. Unintentional damage to the vocal cords during the surgery can result in unwanted conditions such as hoarseness or complete loss of voice.

Another important risk is low calcium levels. The parathyroid glands, which are located close to the surgical site, may be inadvertently removed or disturbed during the surgery, preventing them from functioning properly. This can result in low calcium levels.

To minimize these risks, it is important to carefully choose an experienced and specialized endocrine surgeon. With an expert and experienced surgeon, the likelihood of such negative outcomes is very low.

After a thyroid surgery, patients are usually monitored for one night and discharged the following day after necessary check-ups. It is important to follow the doctor’s instructions during this process.

It is crucial to take the prescribed medications on time and regularly. Especially in cases where the entire thyroid gland is removed, patients need to take the prescribed thyroid hormone medication daily.

In the first few days after the surgery, there may be pain, swelling, and bruising in the area. These are normal and expected effects, and the related side effects will gradually subside over time. During the initial period, it is important to protect the surgical area from trauma.

Due to the proximity of the vocal cords to the surgical site, patients need to obtain approval from their doctors before speaking after the surgery.

Patients can usually return to their normal routine about a week after the surgery, but should avoid strenuous and tiring activities in the initial period.

After thyroid surgery, patients are usually kept under observation overnight and discharged the next day after the controls. In this process, it is necessary to act according to the instructions of the doctors. It is important to use the prescribed drugs on time and regularly. Especially after operations where the entire thyroid gland is removed, patients should use the prescribed thyroid hormone medication every day.

In order to minimize the risks, extra attention should be paid to the selection of the surgeon. In the operation performed by an expert and experienced endocrine surgeon, the probability of such adverse events is extremely low.

Goiter is a disease whose effects differ from person to person. In fact, the reason for this situation is the underlying causes of goiter. Sometimes this situation occurs due to Graves’ disease, and sometimes it can occur due to the exposure of the neck area to radiation. Therefore, the symptoms are different.

Op. Dr Mehmet Altuğ Kazak

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I think Altuğ is a very successful physician. Both my mother had surgery and I had an interview for a treatment. My mother had an operation for this umbilical hernia and we were really pleased with our teacher. His interest and relevance was so good. Even the nurses working with him were people who took care of each patient separately, they were all very interested. At least our teacher can listen to the patient, I think this is a very important feature. I also talked to him about my hemorrhoid treatment and I continue my process with medication. I believe that Altuğ is a young and talented physician in this sense. For this reason, I am continuing my negotiations with the aim of losing weight.

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Ferhat S.

I applied for a thyroid complaint. My surgery went very well and I returned to my normal life within a week. I am very pleased with his friendly approach and treatment and follow-up throughout the treatment process. He is a good doctor who conveys to me what the psychology of the patient is with his attitude and answers all my questions. I would definitely recommend your doctor.

Op. Dr Mehmet Altuğ Kazak