Our hospital provides primarily the following three types of surgical treatment for thyroid diseases. In the vast majority of cases, surgery is performed under general anesthesia.
A total thyroidectomy A total thyroidectomy removes the entire thyroid gland and is the standard treatment. Basedow’s disease causes the thyroid to secrete excessive hormones, and this surgery corrects the problem. Previously, a partial thyroidectomy was used as the standard surgical procedure. The intent was to normalize thyroid hormone production and avoid using oral thyroid hormone replacement therapy following the operation. However, problems tend to arise. If too little of the thyroid gland is taken, hyperthyroidism may recur. On the other hand, removing too much thyroid tissue causes hypothyroidism. Presently, our hospital recommends that patients who are good candidates for surgery undergo complete or nearly complete removal of the thyroid gland. After surgery, patients must take oral thyroid hormone replacement medication, but there is no possibility of recurrence of Basedow’s disease.
Hemithyroidectomy or total thyroidectomy These treatments remove thyroid nodules. Although the surgery will depend on the patient’s specific conditions, the standard approach is to removes the portion of the thyroid gland on the side with the nodule. The parathyroid glands are generally left intact. Partial thyroidectomy is understood to place a relatively small burden on the patient’s body. When nodules requiring surgery are on both sides of the thyroid, then total thyroidectomy may be pursued.
Extent of thyroid resection: partial or total thyroidectomy Extent of lymph node dissection: removal of paratracheal lymph nodes or bilateral cervical lymph nodes The extent of thyroid or lymph node removal depends on the extent of the cancer. Factors include the location of enlarged lymph nodes and the size and number of lesions. Similar to surgery for Basedow’s disease or benign tumors, the parathyroid glands are left intact or transplanted into the neck muscles.