Lobectomy, Thyroid, Adult

ExitCare ImageA thyroid lobectomy is an operation done to remove a part or a whole section (lobe) of the thyroid gland. The thyroid gland is located in the front of the lower neck. The 2 lobes of the thyroid gland are located on the either side of windpipe (trachea) and are joined together by a tissue (the thyroid isthmus). The thyroid gland produces chemicals (hormones) that control your body's metabolism. Surgery may be needed to remove non-cancerous (benign) or cancerous (malignant) tumors of the thyroid. Surgery may also be needed when medicine alone cannot control overproduction of the thyroid hormone.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to dyes, iodine, foods and/or latex.

  • Medications taken including herbs, eye drops, prescription medicines (especially medicines used to "thin the blood"), aspirin or other over-the-counter medications and steroids (by mouth or as a cream).

  • Previous surgery.

  • Previous problems with anesthetics or medicines used to numb the skin.

  • Possibility of pregnancy, if this applies.

  • History of blood clots in your legs and/or lungs.

  • History of bleeding or blood problems.

  • Other important health problems.

RISKS AND COMPLICATIONS

Risks and complications of thyroid lobectomy are rare. The possible complications include:

  • Infection.

  • Bleeding.

  • Hoarseness of voice.

  • Difficulty in swallowing and/or eating.

  • Damage to the glands that regulate the calcium level in the body (parathyroid glands).

  • Scar formation.

BEFORE THE PROCEDURE

Please see "Pre-Surgical and Post-Surgical Guidelines for Patients". Your caregiver will help with any special instructions. Usually, you will be asked not to eat or drink for at least 8 hours prior to the surgery. Your caregiver may ask for certain tests before the surgery. These may include the following:

  • Blood tests to rule out bleeding problems.

  • A chest X-ray.

  • A test that records the electrical activity of the heart (electrocardiogram).

  • Tests to evaluate the functioning of your voice box (vocal cords).

  • A thyroid scan to rule out any cancer.

You may be asked to stop aspirin, any "blood thinner" medicines and ibuprofen before the surgery. If you are taking medicine to reduce the amount of thyroid hormone your body makes, be sure to take this medicine up until the day of surgery, or as instructed by your caregiver.

PROCEDURE

The surgery is usually done under general anesthesia. If so, you will be asleep during the procedure. The surgeon will make an cut (incision) 3 to 4 inches long just above where your collarbone meets the breastbone. The thyroid gland is found by moving the muscles to the side. The diseased part of the gland will be identified and removed. During the procedure, great care is taken to find and preserve the nerves of your voice box. The same is done to find and protect the 4 parathyroid glands located close to the thyroid gland. The removed part of the thyroid is sent to the lab and examined under a microscope. If no cancer is found, the surgery is done and sutures are used to close the skin. If cancer is found, total removal of the thyroid gland may be necessary. Some or all of the lymph nodes in the neck may also need to be removed.

A small drainage tube may be placed in the neck. It helps prevent any buildup of fluid or blood at the surgery site.

AFTER THE PROCEDURE

  • The procedure will usually last 1 to 3 hours. After the surgery, you will be moved to the recovery room. After the anesthesia has worn off, you will be moved to a hospital room.

  • You might feel some pain or soreness in your throat. This may last for 3 to 7 days and can be helped with medicines.

  • After you are in the hospital room, you may be able to start drinking liquids. If liquids are tolerated, you will slowly return to you usual diet.

  • Blood levels of calcium (controlled by the parathyroid glands) will be checked. Even though the parathyroid glands were not removed, they may go into "shock" for a short time and your blood level of calcium may drop.

  • After thyroid lobectomy, you will usually stay in the hospital for a day and get discharged on the morning after surgery.

HOME CARE INSTRUCTIONS

  • You can eat or drink anything you like depending on your comfort.

  • Slowly return to normal activities beginning on the day after your surgery.

  • You can shower or bathe about 24 hours after surgery or after the drain is removed. Be careful to pat the area around the wound dry, if it is wet.

  • In between showing or bathing, a dressing is usually kept over the incision. The dressing will be removed after 2 to 3 days. Follow your caregiver's instructions.

  • Take prescribed medicines as advised.

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver. Do not take aspirin unless directed by your surgeon. Aspirin increases the chances of bleeding.

  • Your surgeon may advise you not to lift heavy objects or play strenuous sports for at least 10 days.

  • You may be told not drive for at least 1 week following surgery. Because muscles of the neck will be stiff and sore, it is difficult to safely look to the sides or behind you while driving. It is also best to avoid driving while taking prescription pain medicine.

  • Usually, a follow-up office or clinic visit will be scheduled 7 to 14 days after surgery. Talk to your caregiver about follow-up appointments.

SEEK MEDICAL CARE IF:

  • You have an oral temperature above 102° F (38.9° C).

  • You develop bleeding, redness, drainage, swelling or excessive pain at the surgery site.

  • The hoarseness in your voice persists more than 7 to 10 days.

  • You feel that you are having problems with any medicine.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop increased swelling in the neck.

  • You have an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • You develop a feeling of "squeezing" or "constriction" in your throat that makes it hard to breathe.