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Partial Thyroidectomy

AMBULATORY CARE:

What you need to know about a partial thyroidectomy:

A partial thyroidectomy is surgery to remove part of your thyroid gland. Your thyroid gland makes hormones that regulate your metabolism, body temperature, and heart rate. Your thyroid gland is shaped like a butterfly. It is found in the front lower part of your neck. You may need a partial thyroidectomy if you have thyroid cancer or a lump on your thyroid. Even a lump that is not cancer can grow large and cause breathing problems. You may also need surgery for hyperthyroidism. This means your thyroid creates too much thyroid hormone.

How to prepare for a partial thyroidectomy:

  • Your healthcare provider will tell you how to prepare for surgery. You may be told not to eat or drink anything after midnight on the day of surgery. Your provider will tell you which medicines to take or not take on the day of surgery. Blood tests are used to check the amounts of calcium and thyroid hormone in your blood. You may be given antithyroid medicine to lower the amount of thyroid hormone made by your thyroid gland.
  • You and your surgeon will decide the kind of surgery that is right for you. A thyroidectomy can be done in several ways. Your surgeon may make an incision in your lower neck. This is called a conventional thyroidectomy. An endoscopic surgery means small incisions are made in your neck. Tools and a small camera are put into the incisions. The camera helps your surgeon find the right area for surgery. A robotic surgery means incisions are made in your chest and armpit, or higher in your neck. Endoscopic and robotic surgeries leave smaller scars that are less visible.
  • An ultrasound may be used to check your thyroid and areas near the thyroid. This will help guide your surgeon during surgery.

  • A thyroid scan may show how well your thyroid is working. You may be given contrast liquid to help the pictures show up better. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid.
  • An MRI may be used to take pictures of your neck muscles, joints, bones, and blood vessels. You may be given contrast liquid to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • Laryngoscopy may be needed before and after your surgery. This test helps your healthcare provider know how well your larynx is working.

What will happen during a partial thyroidectomy:

  • General anesthesia is usually given before a partial thyroidectomy. This medicine will keep you asleep and free from pain during surgery. You may instead be given local anesthesia to numb the area. You may feel some pressure during surgery, but you should not feel any pain.
  • After one or more incisions are made, your surgeon will remove part of your thyroid gland. If you have cancer, your surgeon may also remove the tissue and lymph nodes around your thyroid gland. If you are awake during surgery, you may be asked to speak to your healthcare providers.
  • One or more drains may be placed into your incision to remove extra fluids from the surgery area. Your incision will be closed with stitches or surgical glue and covered with a bandage.

What to expect after a partial thyroidectomy:

Tell your healthcare providers if you have difficulty breathing or swallowing. Tell them if your bandage feels like it is getting tighter. You will have blood tests to check your calcium and thyroid hormone blood levels.

  • Medicine may be given to bring your thyroid hormone level back to normal. A partial thyroidectomy means your thyroid gland can produce some thyroid hormone. You may need to take medicine daily to keep your thyroid hormone level steady. You may be given pain medicine after surgery. Radioactive iodine may be given if your thyroid gland was removed because of cancer. This medicine may kill cancer cells that were not taken out during surgery.
  • Deep breathing helps open air passages and prevent a lung infection. Slowly take a deep breath and hold the breath as long as you can. Then let your breath out. Take 10 deep breaths in a row every hour while awake. You may be asked to use an incentive spirometer to help you with this. Put the plastic piece into your mouth and slowly take a breath as deep and as long as you can. Hold it as long as you can. Then let your breath out.

Risks of a partial thyroidectomy:

You may bleed more than expected and need a blood transfusion. Your voice may be hoarse or weak after surgery, and this may become a long-term problem. Your neck may be bruised and swollen, and it may be hard for you to breathe or swallow. Your parathyroid glands may not work as well as they should after surgery. This can cause your calcium levels to drop too low. Low calcium levels can cause many problems, including an irregular heartbeat, muscle spasms, and seizures. This may be a short-term problem after surgery, or it may be a long-term problem.

Seek care immediately if:

  • You have sudden tingling or muscle cramps in your face, arm, or leg.
  • You have muscle spasms in your legs and feet that do not go away.
  • Blood soaks through your bandage.
  • Your stitches come apart.
  • You have sudden swelling in your neck or difficulty swallowing.
  • You have trouble breathing.
  • You have a seizure.

Contact your endocrinologist or surgeon if:

  • You have a fever or chills.
  • You feel very tired and cold, gain weight for no reason, and your skin is very dry.
  • You vomit several times in a row.
  • Your incision is red, swollen, or draining pus.
  • You have new voice weakness or hoarseness, or it is getting worse.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Thyroid medicine may be needed daily to keep your thyroid hormone level steady.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your endocrinologist or surgeon as directed:

You will need to return to have your wound checked and stitches removed. You may also need blood tests to monitor your calcium, parathyroid, and thyroid hormone levels. Write down your questions so you remember to ask them during your visits.

Wound care:

Check the wound every day for signs of infection, such as redness, swelling, or pus. Carefully wash your skin near the incision wound area with soap and water. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. You can use a mild body lotion to improve the scar.

Supplements:

Ask your endocrinologist if you need to take calcium or vitamin D and how much to take.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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