Our Summary

This research paper explores different surgical approaches to the thyroid gland, particularly focusing on whether minimally invasive surgeries improve the cosmetic outcome (how the scar looks) compared to conventional surgery. The researchers looked at 57 studies, and found that 20 of them reported on the cosmetic outcome of the surgery. However, the studies differed greatly in how they assessed the scar, when they assessed it, and even the method they used to close the wound. The researchers concluded that assessing the cosmetic outcome of a surgery is complex and needs a standardized method. They also found that a scar continues to change and heal for a long time after surgery, which suggests that assessing the scar shortly after surgery might not give the full picture. Based on the studies they looked at, the researchers concluded that minimally invasive surgeries do not necessarily lead to better cosmetic outcomes in the long term compared to traditional surgeries.

FAQs

  1. Do minimally invasive surgeries provide better cosmetic outcomes compared to traditional surgeries?
  2. How did the studies included in the research vary in their assessment of the cosmetic outcome?
  3. Why do the researchers suggest that assessing a scar shortly after surgery may not provide a complete understanding of the cosmetic outcome?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to follow post-operative care instructions carefully to promote proper healing and minimize scarring. This may include keeping the incision area clean and dry, avoiding strenuous activities that could strain the incision site, and attending follow-up appointments to monitor the healing process. Additionally, patients should be patient with the healing process as scars can continue to improve over time.

Suitable For

Patients who are typically recommended for thyroidectomy include those with:

  1. Thyroid cancer: Patients with thyroid cancer may undergo thyroidectomy to remove the cancerous cells and prevent spread to other parts of the body.
  2. Benign thyroid nodules: Thyroid nodules that are causing symptoms such as difficulty swallowing or breathing may require thyroidectomy for removal.
  3. Hyperthyroidism: Patients with hyperthyroidism that does not respond to medication may undergo thyroidectomy to remove a portion of the thyroid gland.
  4. Multinodular goiter: Patients with a large, multinodular goiter may require thyroidectomy to alleviate symptoms such as difficulty swallowing or breathing.
  5. Graves’ disease: Patients with Graves’ disease, an autoimmune disorder that causes hyperthyroidism, may undergo thyroidectomy if other treatments are not effective.
  6. Recurrent thyroid nodules: Patients with recurrent thyroid nodules that continue to grow despite previous treatments may require thyroidectomy for removal.
  7. Thyroid cysts: Patients with large or symptomatic thyroid cysts may undergo thyroidectomy for removal.
  8. Family history of thyroid cancer: Patients with a family history of thyroid cancer may undergo thyroidectomy as a preventative measure.

Overall, the decision to recommend thyroidectomy for a patient is based on their specific condition, symptoms, and risk factors. It is important for patients to discuss the potential risks and benefits of thyroidectomy with their healthcare provider before undergoing the surgery.

Timeline

Here is a brief timeline of what a patient may experience before and after a thyroidectomy surgery:

Before surgery:

  1. Consultation with a healthcare provider to discuss the need for surgery and potential risks and benefits.
  2. Pre-operative testing, such as blood work and imaging scans, to assess the thyroid gland and surrounding structures.
  3. Pre-operative instructions, which may include fasting before surgery and discontinuing certain medications.
  4. Consent form signing.
  5. Anesthesia consultation to discuss anesthesia options and potential side effects.

During surgery:

  1. Administration of anesthesia to induce unconsciousness and prevent pain during the procedure.
  2. Incision made in the neck to access the thyroid gland.
  3. Removal of part or all of the thyroid gland, depending on the reason for surgery.
  4. Closure of the incision using sutures or staples.
  5. Monitoring in the recovery room before being transferred to a hospital room or discharged home.

After surgery:

  1. Pain management to control discomfort at the incision site.
  2. Monitoring of vital signs and thyroid hormone levels.
  3. Potential complications, such as bleeding, infection, or damage to nearby structures, may require additional treatment.
  4. Follow-up appointments with healthcare providers to monitor healing and thyroid function.
  5. Scar care instructions, such as keeping the incision clean and dry, and avoiding sun exposure to prevent scarring.
  6. Long-term monitoring of thyroid function and potential need for thyroid hormone replacement therapy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with thyroidectomy surgery?
  2. How experienced are you in performing thyroidectomy surgeries?
  3. Will I need to take any medications or undergo any further treatments after the surgery?
  4. How long will it take for me to recover from the surgery?
  5. Will I need to make any lifestyle changes following the surgery?
  6. How often will I need to follow up with you after the surgery?
  7. What are the chances of the thyroid cancer coming back after the surgery?
  8. Will I need to have any additional tests or imaging done before the surgery?
  9. Are there any restrictions on activities I should be aware of after the surgery?
  10. Can you explain the process of thyroid hormone replacement therapy after the surgery?

Reference

Authors: Dordea M, Aspinall SR. Journal: Ann R Coll Surg Engl. 2016 Jan;98(1):11-7. doi: 10.1308/rcsann.2016.0022. PMID: 26688393