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Surgery in Thyroid Nodules » How many types of thyroid surgeries?
Bilateral thyroid surgery (Bilateral total thyroidectomy).
- Bilateral surgery is performed for patients with goitre who have nodules in both thyroid glands.
- If papillary thyroid carcinoma identified by biopsy is larger than 1 cm, bilateral thyroid gland is removed.
- In patients with toxic goitre (Graves and multinodular toxic goitre), bilateral surgery is performed to prevent the recurrence of the disease.
- In medullary cancer, bilateral thyroid gland is removed regardless of the tumor size.
Unilateral thyroid surgery (Lobectomy)
- The diseases in which only the right or left lobe is removed are very few. A sample for these is papillary thyroid carcinoma patients who have nodules less than 1 cm and who do not have any nodule in another lobe.
- A single lobe is removed in patients with toxic adenoma who have a single nodule that is secreting excessive amount of hormone.
- Patients who have a single nodule in the thyroid gland and whose biopsy result is not exactly cancer. However, it should be very well explained to the patient that again a surgery may be needed if the cancer recurs after surgery.
Nowadays, thyroid tissue is not left behind when thyroid surgery is performed. In some patients, a very small amount of tissue may remain to protect the nerve, but the surgeries, in which more thyroid tissue is left behind, should not be performed since they pose a problem.
Should pathologic examination (frozen) be performed during the operation?
Frozen section examination is not performed in patients who are diagnosed with cancer by needle biopsy. Frozen can be requested for patients with "cancer suspicion". If a suspicious lymph node is seen during the operation, Frozen section examination is performed and the surgery technique is decided. If metastasis is detected in Frozen examination, the patient's lymph nodes are also removed.
Is there a device that prevents nerve damage?
Devices that make it easier to find the nerve can be used in thyroid surgery. The use of these devices does not reduce the risk of complications, but makes it easier to detect the nerve. The use of this technique is strongly recommended in secondary neck surgeries.