Do I still need to worry about my surgery?
Thyroid Surgeries are Safe surgeries with minimal risks. Speak to your surgeon before Surgery and clarify all your doubts and concerns. Your surgeon will allay all your fears regarding the surgery.
Are there any complications during or after thyroid surgery?
Thyroid surgery is generally a safe procedure. The vast majority of patients undergoing an operation on the thyroid gland have no complications.
However, as with any surgical procedure, there are some risks associated with the operation and these will be fully explained to you by your surgical team.
Will I need Thyroid replacement tablets after my operation?
Patients who have had a total thyroidectomy or near-total thyroidectomy will need thyroid tablets postoperatively and this will be life long.
What are the potential complications that I should know?
The thyroid gland is close to many nerves and blood vessels and hence the surgery carries a minor risk involving injury to these structures. These are more likely to occur in patients undergoing Surgery for cancer Lymph node surgery Surgery for a large thyroid (goiter) Revision thyroid or lymph node surgery
Nerve Injury: There are nerves running in close proximity to the thyroid gland which is responsible for the quality and the pitch of your voice – Recurrent laryngeal nerves and the superior laryngeal nerves one each on each side. Injury to these nerves may result in a change in voice These voice changes are usually transient lasting for few days to few weeks. However, in very rare scenarios especially in thyroid cancer surgeries, there is a minimal risk of permanent voice damage. Hence professionals whose career involves their voice – like singers and teachers need to discuss with your surgeon prior to surgery. Uncommonly injury to laryngeal nerves on both sides may warrant placing a breathing tube through the windpipe (tracheostomy). In most instances, it is short-term.
Low Calcium levels: We have four parathyroid glands, two on each side, each about the size of a grain of a lemon seed attached behind the thyroid gland. They are involved in regulating calcium levels in the blood. Normally the surgeon identifies and saves some or all of these glands.
However, during thyroid surgery the parathyroid glands can be bruised, damaged, or excised, causing low calcium levels in blood manifested by a sensation of tingling in the fingers and lips (pins and needles sensation) and/or cramps in the fingers. Even if the parathyroid glands are saved, there may be stunning of the glands causing low calcium levels for several days to weeks. These may be managed by replacing calcium usually orally by tablets.
Other Potential Complications
Neck Numbness: Some patients may experience numbness around the thyroid surgery scar after their operation. This usually subsides with time.
Swallowing Difficulties: Mild swallowing difficulties may occur usually pain-related improves with analgesics
Wound related issues: Swelling around the wound may be seen for a few days – these are usually normal after surgery. Wound Infections are rarely seen Occasionally fluid may accumulate behind the wound called a seroma. Normally subsides with time.
Thyroid Storm: An Extremely rare complication in patients with the overactive thyroid gland (thyrotoxic patients) undergoing surgery Caused by a sudden excessive amount of thyroid hormone released into the bloodstream during surgery. Hence all thyrotoxic patients must be put on medications to achieve normal thyroxine levels prior to surgery.
Do I need to come for suture removal?
Normally an absorbable suture would be placed at the operative site and may not require removal of sutures. In case of any nonabsorbable suture usage, your surgeon will let you know when can they be removed. Thyroidectomy is not a particularly painful operation and pain relief is rarely necessary after 72 hours. It is normal to feel tired following thyroid surgery and it may take up to a month before you feel you have your energy levels back.
When can I take a shower?
You can take a normal shower 24 hrs after removing the drain tube. After a shower, just dab the wound dry with a soft towel. However any excessive soakage at the drain or wound site will need to be informed to the surgeon and wetting the wound may be delayed.
How do I take care of my wound?
Normally a dressing will be present on the operative site for about 24 hrs which will be removed on the next day of surgery. No special care may be required except keeping the wound dry and clean. A tube may be in place to drain out excess fluid from the operation site. This may usually be removed 24 – 48 hours after surgery.
How long will I be in the hospital?
This depends very much on the exact diagnosis and the operation being performed. Usually the stay in the hospital post-surgery may vary between 24 - 48hours.
What are all the preoperative preparations required prior to surgery?
Routine Pre-operative investigations including thyroid function tests and radiological imaging tests will be done. Your vocal cords will be examined by another doctor in the hospital by passing a small nasal endoscope through your nose. This is a very quick and safe test done usually lasting less than a minute without much discomfort. An anaesthesiologist will evaluate you and give you the information what you need to know regarding the type of anaesthesia You will be asked to be on empty stomach for 6 hours prior to surgery
What are the precautions I need to take prior to surgery?
Inform your surgeon and anaesthesiologist about any medications you are on including Thyroid medications. They may need to be continued even on the day of surgery with sips of water. If you are on any blood-thinning or antiplatelet medications like aspirin, clopidogrel, inform your surgeon – these may need be stopped 3-5 days prior to surgery.