Thyroidectomy

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Thyroidectomy
Thyroid Surgery.jpg
Thyroid surgery
ICD-9-CM 06.3-06.5
MeSH D013965

A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. In general surgery, endocrine or head and neck surgeons often perform a thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland (such as hyperthyroidism) or goiter. Other indications for surgery include cosmetic (very enlarged thyroid), or symptomatic obstruction (causing difficulties in swallowing or breathing). Thyroidectomy is a common surgical procedure that has several potential complications or sequelae including: temporary or permanent change in voice, temporary or permanently low calcium, need for lifelong thyroid hormone replacement, bleeding, infection, and the remote possibility of airway obstruction due to bilateral vocal cord paralysis. Complications are uncommon when the procedure is performed by an experienced surgeon. [1]

Contents

The thyroid produces several hormones, such as thyroxine (T4), triiodothyronine (T3), and calcitonin. After the removal of a thyroid, patients usually take a prescribed oral synthetic thyroid hormone—levothyroxine (Synthroid)—to prevent hypothyroidism, the deficiency of these hormones.

Variants

Less extreme variants of thyroidectomy include:

Traditionally, the thyroid has been removed through a neck incision that leaves a permanent scar. More recently, minimally invasive and "scarless" approaches such as transoral thyroidectomy have become popular in some parts of the world. These approaches have been associated with reduced pain and better quality of life in some studies. [2] [3] There are a few centers of excellence in the United States that perform this surgery often, while most centers do not routinely offer remote access surgery. Traditional thyroid surgery is a common procedure, performed over 100,000 times per year. [4] [5] [6]

A thyroidectomy should not be confused with a thyroidotomy (thyrotomy), which is a cutting into (‑otomy) the thyroid, not a removal ( ‑ectomy , literally “out-cutting”) of it. A thyroidotomy can be performed to get access for a median laryngotomy, or to perform a biopsy. (Although technically a biopsy involves removing some tissue, it is more frequently categorized as an ‑otomy than an ‑ectomy because the volume of tissue removed is minuscule.)

Uses

Thyroidectomy is used in the treatment of:

Types

A lobectomy of the thyroid gland Diagram showing a lobectomy of the thyroid gland CRUK 067.svg
A lobectomy of the thyroid gland
A total thyroidectomy Diagram showing before and after a total thyroidectomy CRUK 106.svg
A total thyroidectomy

Complications

History

Al-Zahrawi, a tenth century Arab physician, sometimes referred to as the "father of surgery", [12] is credited with the performance of the first thyroidectomy. [13]

See also

References

  1. Weiss, A (28 September 2015). "Outcomes of thyroidectomy from a large California state database". Thyroidology. 8 (12): 3–4.
  2. Nguyen, Hau Xuan; Nguyen, Hain Xuan; Le, An Duc; Le, Quang Van (18 January 2022). "Comparison of Transoral Endoscopic Thyroidectomy Vestibular Approach and Conventional Open Thyroidectomy in Benign Thyroid Tumors". Indian J Surg Oncol. 13 (1): 178–183. doi:10.1007/s13193-022-01494-x. PMC   8986896 . PMID   35462668.
  3. Nagururu, NV; Seo, S; Ding, AS; Grogan, R; Wolfe, SA; Harbison, RA; Tufano, RP; Russell, JO (July 2024). "Long-term Quality of Life After Thyroidectomy: Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Transcervical Approach". Otolaryngology–Head and Neck Surgery. 171 (1): 45–53. doi:10.1002/ohn.712. PMID   38488229.
  4. Sun GH, DeMonner S, Davis MM. Epidemiological and economic trends ininpatient and outpatient thyroidectomy in the United States, 1996–2006. Thyroid. 2013;23:727–733.
  5. Rubio GA, Koru-Sengal T, Vaghaiwalla TM, Parikh PP, Farra JC, Lew JI. Postoperative outcomes in Graves' disease patients: results from the nationwide inpatient sample database.Thyroid. 2017;27:825–831.
  6. Patel, Kepal N.; Yip, Linwah; Lubitz, Carrie C.; Grubbs, Elizabeth G.; Miller, Barbra S.; Shen, Wen; Angelos, Peter; Chen, Herbert; Doherty, Gerard M.; Fahey, Thomas J.; Kebebew, Electron (March 2020). "The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults". Annals of Surgery. 271 (3): e21 –e93. doi:10.1097/SLA.0000000000003580. ISSN   0003-4932. PMID   32079830.
  7. Mathur AK; GM Doherty (2010). "Ch. 1: Thyroidectomy and Neck Dissection". In Minter RM; GM Doherty (eds.). Current Procedures: Surgery. New York: McGraw-Hill.
  8. Cooper, Dominic; Kaur, Rajneesh; Ayeni, Femi E.; Eslick, Guy D.; Edirimanne, Senarath (8 July 2024). "Hypothyroidism after hemithyroidectomy: a systematic review and meta-analysis". Thyroid Research. 17 (1) 18. doi: 10.1186/s13044-024-00200-z . PMC   11229296 . PMID   38972987.
  9. Dr. Gianlorenzo Dionigi, Francesca Rovera, Luigi Boni, Patrizia Castano, and Renzo Dionigi. Surgical Infections. Summer 2006, 7(supplement 2): s-117-s-120. http://online.liebertpub.com/doi/abs/10.1089/sur.2006.7.s2-117
  10. Elfenbein, Dawn M.; Schneider, David F.; Chen, Herbert; Sippel, Rebecca S. (2014-07-01). "Surgical site infection after thyroidectomy: a rare but significant complication". The Journal of Surgical Research. 190 (1): 170–176. doi:10.1016/j.jss.2014.03.033. ISSN   1095-8673. PMC   5125385 . PMID   24739508.
  11. Identifying preoperative risk factors for surgical wound infections in clean cases , retrieved 2016-10-30
  12. Ahmad, Z. (St Thomas' Hospital) (2007), "Al-Zahrawi – The Father of Surgery", ANZ Journal of Surgery, 77 (Suppl. 1): A83, doi:10.1111/j.1445-2197.2007.04130_8.x, S2CID   57308997
  13. Ignjatovic M: Overview of the history of thyroid surgery. Acta Chir Iugosl 2003; 50: 9–36.

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