| Many thyroid problems can be effectively treated | | | | for surgical removal; and finally if the goitre has |
| without the necessity of having to undertake a surgical | | | | resulted in compression of the trachea, which can lead |
| procedure but there are instances where a doctor | | | | to respiratory problems or infection, or has culminated |
| might decide that thyroid surgery is the best possible | | | | in arterial compression, which can cause cerebral |
| course of action - or perhaps even the only course | | | | hypoperfusion and perhaps induce a stroke. |
| open. | | | | The most common reason for thyroid surgery to be |
| If a patient has a thyroid nodule and it has continued to | | | | carried out, however, remains thyroid cancer. Although |
| grow despite possible fluid removal or the prescribing | | | | on these occasions it is possible to have a partial |
| of thyroxine, a doctor might conclude that surgery is | | | | thyroidectomy, in general doctors prefer to remove the |
| necessary. Similarly, if the nodule is causing the patient | | | | complete thyroid in a total thyroidectomy, which will be |
| pain or undue anxiety. Many doctors consider that | | | | more likely to prevent the cancer's return at a later |
| once a nodule has a diameter in excess of 4 | | | | date. A partial thyroidectomy is likely to be carried out |
| centimetres it should be operated upon. The Hot | | | | only for a papillary or follicular cancer that is less than a |
| nodules (those stimulating the production of the thyroid | | | | centimetre in width - and technically still in T1 stage. For |
| hormone) are generally treated by either radio-iodine or | | | | those cancers that have been diagnosed as being |
| surgery, and some patients will opt for the surgical | | | | medullary or anaplastic thyroid cancers (as well as |
| procedure because of their concernsover radio-iodine | | | | larger papillary and follicular tumours) it is more |
| therapy. | | | | common to remove the whole of the thyroid. |
| Indications are that the risk of developing | | | | Complete removal of the thyroid will result in the |
| hypothyroidism as a result of having a nodule surgically | | | | patient then needing to take thyroid hormone |
| removed for this reason is very low. Likewise, most | | | | replacement tablets on a daily basis. |
| multinodular goitres can be treated without recourse to | | | | As with all surgical operations, there is an element of |
| surgery. Again, though, there are times when surgery | | | | risk involved in thyroid surgery, albeit a very small one. |
| becomes necessary. For example, surgery is indicated | | | | Reactions to anaesthetics, infections or excess |
| if the goitre continues to grow despite treatment; if the | | | | bleeding remain potentially harmful but, generally, thyroid |
| goitre has become toxic; if a patient has developed an | | | | surgery is considered a relatively safe and predictable |
| unsightly looking lump and wants it removed for | | | | procedure. The most likely possible complications |
| predominantly cosmetic reasons; if the goitre is | | | | specific to thyroid surgery are damage to the laryngeal |
| substernal - in other words situated inthe lower part of | | | | nerve, which might result in hoarseness for a little while |
| the isthmus of the thyroid gland and difficult to locate | | | | or, in extreme cases, permanent damage and |
| and observe - and is considered to be most suitable | | | | hypothyroidism, which would then be medically treated. |