Our Summary

This research paper is about the risks associated with using steroids for a long time, particularly for patients who are about to undergo surgery to remove the thyroid gland. The study looks at the outcomes of these types of surgeries from 2005 to 2018. They found that people who were using steroids had more complications after the surgery compared to those who weren’t, including issues related to the surgical site, heart and lung problems, kidney problems, and a higher chance of being readmitted to the hospital. The study concludes that using steroids for a long time before having thyroid surgery can increase the risk of complications, so further research is needed to understand how to best manage steroid use before surgery to improve patient outcomes.

FAQs

  1. What is the main focus of the research paper on long-term steroid use and thyroidectomy?
  2. What are the potential complications for patients using steroids before undergoing thyroid surgery?
  3. What does the research suggest about managing steroid use before thyroid surgery to improve patient outcomes?

Doctor’s Tip

A helpful tip a doctor might tell a patient about thyroidectomy is to discuss with their healthcare provider any medications they are currently taking, particularly steroids, as they can increase the risk of complications during and after surgery. It is important to follow the doctor’s recommendations and guidelines for managing medication use before undergoing a thyroidectomy to minimize potential risks and ensure a successful outcome.

Suitable For

Patients who are typically recommended thyroidectomy include those with:

  1. Thyroid cancer: Thyroidectomy is often recommended for patients with thyroid cancer to remove cancerous thyroid nodules or tumors.

  2. Hyperthyroidism: Patients with hyperthyroidism, a condition in which the thyroid gland produces too much thyroid hormone, may undergo thyroidectomy to remove part or all of the thyroid gland.

  3. Large goiters: Patients with large goiters, which are noncancerous growths on the thyroid gland, may require thyroidectomy if the goiter is causing symptoms such as difficulty swallowing or breathing.

  4. Graves’ disease: Thyroidectomy may be recommended for patients with Graves’ disease, an autoimmune disorder that causes the thyroid gland to become overactive.

  5. Thyroid nodules: Thyroidectomy may be recommended for patients with thyroid nodules that are causing symptoms or are suspicious for cancer.

  6. Recurrent thyroid nodules: Patients with recurrent thyroid nodules may undergo thyroidectomy to prevent further growth or to remove nodules that are causing symptoms.

  7. Familial thyroid cancer: Patients with a family history of thyroid cancer or certain genetic mutations may be recommended for thyroidectomy as a preventive measure.

Overall, the decision to recommend thyroidectomy for a patient will depend on their specific condition, symptoms, and risk factors. It is important for patients to discuss their options with their healthcare provider to determine the best course of treatment for their individual case.

Timeline

Before Thyroidectomy:

  1. Patient is diagnosed with a thyroid disorder, such as hyperthyroidism, hypothyroidism, or thyroid cancer.
  2. Patient undergoes preoperative testing, which may include blood tests, imaging scans, and a consultation with an endocrinologist or surgeon.
  3. Patient may be prescribed medications to manage symptoms and prepare for surgery, such as thyroid hormone replacement therapy or beta blockers.
  4. Patient may need to make lifestyle changes, such as adjusting their diet or stopping certain medications before surgery.
  5. Patient meets with the surgical team to discuss the procedure, potential risks, and postoperative care.

After Thyroidectomy:

  1. Patient undergoes the thyroidectomy procedure, which can be done through a traditional open surgery or minimally invasive techniques like laparoscopic or robotic surgery.
  2. Patient is monitored closely in the hospital for any complications, such as bleeding, infection, or damage to nearby structures like the parathyroid glands or recurrent laryngeal nerve.
  3. Patient may experience temporary or permanent changes in hormone levels, which may require ongoing medication or hormone replacement therapy.
  4. Patient undergoes follow-up appointments with their healthcare provider to monitor their recovery, check thyroid hormone levels, and address any concerns or complications.
  5. Patient may need to make long-term lifestyle changes, such as dietary modifications or regular thyroid hormone monitoring, to manage their thyroid disorder effectively post-surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with thyroidectomy surgery?
  2. How will my thyroidectomy surgery be performed and what is the expected recovery time?
  3. Are there any specific pre-operative tests or preparations I should be aware of?
  4. How will my thyroid hormone levels be monitored and managed after the surgery?
  5. What are the potential long-term effects of having my thyroid gland removed?
  6. Are there any alternative treatment options to thyroidectomy that I should consider?
  7. How will my medication regimen, including any steroids I may be taking, be adjusted before and after the surgery?
  8. What are the chances of complications related to steroid use in relation to the surgery?
  9. What steps can I take to reduce the risks associated with using steroids before thyroid surgery?
  10. Are there any specific lifestyle changes or precautions I should take before and after the surgery to optimize my recovery and minimize complications?

Reference

Authors: Mamidi IS, Fassas S, Pasick LJ, Benito DA, Lee R, Joshi AS, Goodman JF, Thakkar P. Journal: J Surg Res. 2021 Nov;267:17-24. doi: 10.1016/j.jss.2021.04.042. Epub 2021 Jun 11. PMID: 34120016