Post Thyroidectomy Complication

Surgery is one of the modern advances in Medicine. There are so many diseases which could not be cured before but with the advent of Surgery now become a routine success.

However, the Achilles heal of Surgery is the Surgical Complications. Although most surgical operations done by a well trained surgeon will go smoothly without any complication. Complications loom in every single operation nonetheless.

I have done so many Thyroidectomy ie. operation to remove thyroid glands during my surgical career. There are usually three possible complications that may occur after thyroid operations;

- hoarseness due to nerve injury

- cramps due to damage to the parathyroid glands

- bleeding

The above picture shows a patient after undergoing a thyroid operation suffering from a complication of minor bleeding post surgery. The central neck swelling is due to bleeding under the skin.This is confirmed by an ultrasound examination. Since the bleeding is small and the blood was quite solid clot, there is no specific treatment needed here. With time, the blood clot will be resorbed by the surrounding tissues.The Surgical scar is seen to be fully healed.

Total Thyroidectomy For Thyroid Cancer

This is an intact specimen of the whole thyroid gland after Total Thyroidectomy.

There is a tumour in the centre part of the gland which is called the Isthmus.

The tumour happens to be a Thyroid Cancer which is diagnosed by a biopsy technique called Fine Needle Aspiration Cytology.

Although the cancer just involve the isthmus, but to effectively treat thyroid cancer, a total Thyroidectomy is necessary.

Post total Thyroidectomy, patient will be rendered Hypothyroid, which means the thyroid hormone level is below normal. In order to sustain normal living,patients have to consume daily thyroxine hormones for life.

Quite often patients will ask what happen if they unwittingly forget to take the hormone tablets. Since the half-life of thyroxine is about 1 week, missing tablets for one or two days is of no consequent as long as its not more than 1 week.

It is noted that many surgeons are not keen to perform Thyroidectomy, especially Total Thyroidectomy in the private sector setting for 2 main reasons;

1. (Total) Thyrodectomy carries real risk of Recurrent Laryngeal Nerve injury which may affect voice changes postoperatively

Thyroidectomy To Treat Goitres

Thyroid diseases are common medical conditions that require surgical treatment.

Not all thyroid diseases need surgery.

In general, thyroid diseases are categorized into 2 forms;

1.Structural diseases-Nodular diseases-Goitre

2.Functional diseases-Hyper or hypothyroidism

3.Hybrid conditions-combinations of both diseases

In general,structural diseases are treated by surgery and functional diseases are treated medically.For some functional diseases that fail medical treatment,surgery may be necessary.

2 forms of surgery commonly done are;

1.Lobectomy or Hemithyroidectomy or Partial Thyroidectomy

2.Total Thyroidectomy

Benign partial goitre is treated by Lobectomy

Malignant goitre or total goiter are treated Total Thyroidectomy

A common generalized/total goiter is often called Multinodular Goitre large enough causing compressive symptoms mandating Total Thyroidectomy(pic. above)