Thyroid surgery is one of the procedures in my surgical repertoire that I really enjoy and do a lot of (approximately 40 to 50 per year for the last 8 years!) Over the years, I have encountered some common questions from my patients that I have compiled below.
This is an odd question although I can understand the anxiety behind it. I do have a standard answer for this and it goes like this: if by ‘major’, the patient worries about dying or having life-threatening complications post-operatively, or expects to be bed-bound for days suffering in pain, then the answer is ‘no’. If however, the patient expects the surgery to be over within an hour, be discharged the same day and return to work the next, then the answer is also ‘no’. The reality is that the surgery can take up to 3 hours (depending on the extent of the surgery), the patient stays in hospital 1-2 days after surgery, and she can eat, talk and walk immediately after the surgery with minimal discomfort.
Even though a change in voice or hoarseness is one of the major complications of a thyroid surgery, the patient very rarely loses the voice completely. Instead, a transient period during which she experiences a slight hoarseness or strength in voice is probably the most common result. The actual impact is often affected by the patient’s expectations and whether she is a professional voice user.
Surprising, the most common feedback from my patients is a sore throat rather than post-surgical wound pain. This is usually due to the ventilating tube that was used during surgery. My patients are expected to eat, talk and walk as per normal after surgery. There may be drains which are fine tubes connected to small bottles but these are removed before the patient is discharged home. Some blood tests are done to check that the calcium levels are normal before being discharged.
There is a common concern amongst my female patients that they will become overweight after completely removing the thyroid gland. The misconception stems from the fact that patients need to be on lifelong thyroid hormone replacement. On the contrary, a patient on the correct dose of hormone replacement coupled with a regular diet and exercise, should not experience any change in her weight or lifestyle.
No, especially if the thyroid condition is benign and the gland is removed by an experienced thyroid surgeon. Sometimes a benign problem may return if the surgery previously performed is less than a total thyroidectomy. If the condition stems from a cancer, there is definitely a risk of future recurrence depending on the aggressiveness of the cancer and the follow up treatment.
1. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid AssociationGuidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26(1), 2016.
2. ATA guidelines for assessment of thyroid nodules.
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