Why is the procedure done?

Thyroidectomy with lymph node excision is done when the thyroid gland is affected by cancer. The cancer might spread to areas near the gland like the lymph nodes,  necessitating their removal as they can hasten the spread of the cancer.

How does the procedure work?

Before the Procedure

It is important to discuss the following points with the doctor before the surgery:

• Allergies
• Current medications
• Medical history
• The patient may need some pre operative investigations
• Risks of the surgery will need to be explained and consent taken

During the Procedure

• Local/ general anaesthesia will be given (depending upon the medical requirement)
• Heartbeat, blood pressure and all other vitals will be under check throughout the procedure
• An incision will be made in the front of the neck , where the skin folds,  so that once it heals, the resultant scar will be less visible.
• Breathing tube will be placed into the system to assist the patient breathe during the procedure.
• The thyroid gland (whole or part of it) will be removed.
• The surgeon will check for cancer affected lymph nodes near the thyroid gland and remove those as well, if needed.
• The procedure can be endoscopic  (through insertion of endoscope through small incisions) or conventional.

After the Procedure

• The patient will be moved to the recovery room for observation.
• If no other complications are found, the patient can leave the hospital the next day itself.
• Medications will be given to relieve pain
• Radio-active iodine treatment will have to be done in some cases to track and destroy any remaining cancerous tissues in the gland.
• The patient might have to take liquid or semi-solid food during the initial days. The diet can be fixed as per the doctor’s suggestion.
• The patient can begin doing normal chores within a day or two following the procedure.
• The patient needs voice rest for one to two weeks after the procedure and it is better to avoid straining the voice even afterwards.
• The patient will meet with the doctor in four weeks after the procedure for follow up checks.

Benefits of the Procedure

• Completely removes the cancerous cells and helps to cure the condition
• The scar from the surgery will be hidden in the folds of the neck skin and will fade away over time, making it less visible.

Risks of the Procedure

This procedure carries some potential risks like most other surgeries, such as:

• Infection
• The instruments or devices can cause injury to the laryngeal nerves, thus affecting the voice quality
• The radio-active iodine treatment may lead to nausea, neck tenderness, dry mouth, loss of taste etc
• Allergic reaction to anaesthesia

Conclusion

Thyroidectomy with lymph node excision is done when thyroid gland tissues develop cancer  and it spreads to lymph nodes near the gland. It can be done either through open or endoscopic method.