Thyroid surgery is a procedure to remove part or all of the thyroid, which is a butterfly-shaped gland in the neck that produces hormones that regulate metabolism, growth, and temperature. Although it plays an important role as a treatment for thyroid disorders, thyroid surgery still has side effects.
Thyroid surgery is generally performed in severe thyroid disease, such as thyroid cancer, or a goiter that has interfered with swallowing or breathing. In addition, thyroid surgery is also used when medications or other treatment methods don't work.
However, thyroid surgery is not always applicable to all patients with thyroid disease. Patients with severe and uncontrolled hyperthyroidism, or patients who are pregnant are some of the conditions that are not recommended to undergo this surgery.
Based on the part of the gland that is removed, thyroid surgery is divided into 3 types, namely:
Thyroid lobectomy
In this surgery, part or half of the thyroid gland will be removed. Usually this method is done to remove a tumor or a small enlargement of the thyroid.
Thyroidectomytotal
This type of thyroid surgery is performed by removing the entire thyroid gland.
Thyroid biopsy
Surgery to remove part of the thyroid tissue, for further examination in the laboratory. A thyroid biopsy is performed to determine whether a thyroid tumor is benign or malignant.
Preparation Before Thyroid Surgery
A few days before the operation, the doctor will first evaluate the patient's health condition thoroughly. This evaluation can be in the form of a physical examination and supporting, such as blood tests, X-rays, and ECG.
In addition to confirming the patient's condition, the results of this preoperative evaluation also determine the type of anesthesia (anaesthesia) to be used in the operation and which part of the thyroid needs to be removed.
There are several things that need to be considered when undergoing preparation before surgery, namely:
- All types of thyroid surgery use anesthesia. If you have a history of allergies to the anesthetic to be used, the patient is required to inform the doctor during the preoperative examination.
- Patients also need to tell their doctor if they are taking certain supplements, herbal products, or medications. It is feared that the drugs being used can cause drug interactions with anesthetic drugs, and cause dangerous side effects during or after surgery.
- Avoid smoking and alcoholic beverages for at least 2 weeks before surgery.
- The doctor will determine when the patient starts fasting. Patients are usually instructed to fast for a few hours before surgery, in order to reduce the risk of complications from the use of anesthesia.
Thyroid Surgery Procedure
Some time before the operation begins, the doctor will re-examine the patient's condition. This is to ensure the patient's readiness for surgery.
After the condition is declared ready, the patient will then be escorted to the operating room. In the operating room, the doctor will provide anesthesia, either by injection or a breathing mask. During surgery, the patient's vital signs including blood pressure and blood oxygen levels will continue to be evaluated through a monitor.
When the patient is under anaesthesia, the anesthesiologist will provide a breathing apparatus through a special tube (endotracheal tube) that is inserted into the throat, to help the patient breathe during the operation.
After that, the surgeon will clean the area to be cut (the area under the neck) using an antiseptic solution. The size of the incision is not always the same in every patient, depending on the part of the thyroid gland that is removed and the method of thyroid surgery used.
The following are 3 methods of thyroid surgery that can be used to remove the thyroid gland:
Conventional Operation
This method requires an incision of approximately 5-12 cm in the middle of the neck, so that the doctor can directly access the problematic thyroid gland and remove it.
Endoscopic surgery
This method of surgery uses a special instrument called an endoscope, which is a tube with a tiny camera on the end, to remove the thyroid gland. The advantage is that the incision required for endoscopic surgery is much smaller than conventional surgery, which is about 0.5 to 1 cm.
Robotic surgery
The operation process is completely carried out with the help of robots. The difference with endoscopic and conventional surgery, the incision required for robotic surgery is only 8 mm. However, this surgical technique is still not widely used in Indonesia.
Thyroid surgery generally lasts about 1-2 hours, but it is possible for the operation to take longer than that.
Post Thyroid Surgery
After the operation, the incision will be sutured and then covered with a waterproof tape to protect the surgical scar while the patient is bathing. The doctor will then transfer the patient to the postoperative recovery room to rest and be evaluated for at least 4-6 hours.
If the incision is large and there is concern about bleeding, the doctor will usually install a special tube and tube to collect any blood that may be leaking out. The hose and tube can be removed the next day.
After thyroid surgery, patients generally need to stay in the hospital for a few days. The patient was allowed to go home after his condition was stable and postoperative pain had reduced. However, patients should avoid strenuous activities for at least 10-14 days.
The Risk of Side Effects of Thyroid Surgery
Like surgery in general, thyroid surgery can also cause complications. Some of the risks of complications that can occur after thyroid surgery are:
- Postoperative bleeding.
- Pain in the neck or painful swallowing.
- Hoarseness.
- Injury or injury to the tissues around the thyroid, such as the nerves, lymph nodes, or parathyroid glands. Injury to the parathyroid glands can cause hypoparathyroidism.
- Infection.
- Decreased production of thyroid hormone drastically (hypothyroid).
Although rare, thyroid surgery can also cause complications such as thyroid storm or thyrotoxicosis. Symptoms include frequent restlessness, digestive disturbances such as abdominal pain and diarrhea, body shaking (thermor), profuse sweating, fast heart beat, and fever.
Given these risks, a complete examination and careful preparation need to be done before deciding to undergo thyroid surgery.
If you suffer from thyroid disease that requires surgery, consult your doctor to find out what preparations are needed, and what side effects may occur.
