Our Summary

This study looked at the complications that can occur after a particular surgery – a total thyroidectomy – in patients with and without Graves’ disease. Graves’ disease is an autoimmune illness that affects the thyroid. The surgery - total thyroidectomy - involves removing the entire thyroid.

The researchers used a large database of surgical outcomes from US hospitals from 2007 to 2017 to compare the rates and types of complications in these two groups. They excluded patients who had cancer or had only a part of their thyroid removed.

The results showed that people with Graves’ disease who had this surgery were more likely to be readmitted to hospital, needed more repeat surgeries, and had more complications after surgery. These complications included problems with the wound healing, low calcium levels, and bleeding or blood clots.

Even after matching patients with Graves’ disease to similar patients without the disease, the results remained the same.

The study concludes that people with Graves’ disease have a higher risk of complications after thyroid surgery compared to those without Graves’ disease. However, the overall rate of complications was still relatively low, which suggests that the surgery is not too risky and could still be an option for some patients with Graves’ disease.

FAQs

  1. What is a total thyroidectomy and how is it related to Graves’ disease?
  2. What are the possible complications after a total thyroidectomy, particularly in patients with Graves’ disease?
  3. According to the study, is thyroid surgery still a viable option for patients with Graves’ disease despite the higher risk of complications?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to closely monitor for any signs of complications after surgery, especially if they have Graves’ disease. It is important to follow up with your healthcare provider regularly and report any unusual symptoms or concerns. Additionally, be sure to follow your doctor’s post-operative care instructions carefully to help prevent complications and promote optimal healing.

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 tissue.

  2. Graves’ disease: Patients with Graves’ disease may undergo thyroidectomy if other treatments, such as medications or radioactive iodine therapy, are not effective or appropriate.

  3. Large goiter: Patients with a large goiter (enlarged thyroid gland) that causes symptoms such as difficulty breathing or swallowing may undergo thyroidectomy.

  4. Hyperthyroidism: Patients with severe hyperthyroidism that does not respond to other treatments may undergo thyroidectomy.

  5. Suspicious nodules: Patients with nodules on the thyroid that are suspicious for cancer may undergo thyroidectomy to remove the nodules for further evaluation.

  6. Recurrent thyroid nodules: Patients with recurrent thyroid nodules that cause symptoms or are concerning for cancer may undergo thyroidectomy.

  7. Thyroid nodules causing compression: Patients with thyroid nodules that are causing compression of nearby structures, such as the trachea or esophagus, may undergo thyroidectomy.

It is important for patients to discuss their individual circumstances with their healthcare provider to determine if thyroidectomy is the best treatment option for them.

Timeline

Before the thyroidectomy:

  1. Patient is diagnosed with Graves’ disease, an autoimmune illness affecting the thyroid.
  2. Patient undergoes preoperative evaluations and consultations with healthcare providers.
  3. Surgery date is scheduled and patient is instructed on preoperative preparations.
  4. Patient may undergo preoperative tests such as blood work and imaging studies.
  5. Patient receives anesthesia and the total thyroidectomy surgery is performed.

After the thyroidectomy:

  1. Patient is monitored in the recovery room post-surgery for any immediate complications.
  2. Patient may stay in the hospital for a few days for observation and management of postoperative symptoms.
  3. Patient may experience temporary hoarseness, difficulty swallowing, or neck pain.
  4. Patient is discharged from the hospital with instructions for postoperative care and follow-up appointments.
  5. Patient may need to take thyroid hormone replacement medication for the rest of their life.
  6. Patient may experience complications such as wound healing issues, low calcium levels, or bleeding/clots post-surgery.
  7. Patient may require readmission to the hospital, repeat surgeries, or further treatment for complications.
  8. Patient continues to have regular follow-up appointments with healthcare providers to monitor thyroid hormone levels and overall health.

What to Ask Your Doctor

  1. What are the potential complications of a total thyroidectomy surgery for someone with Graves’ disease?
  2. How likely is it that I will experience complications after the surgery?
  3. What measures will be taken to minimize the risk of complications during and after the surgery?
  4. How long is the recovery period expected to be after a total thyroidectomy for someone with Graves’ disease?
  5. Will I need to take any medication or supplements after the surgery to manage any potential complications?
  6. Are there any specific lifestyle changes I should make after the surgery to support my recovery and reduce the risk of complications?
  7. How often will I need to follow up with you after the surgery to monitor for any potential complications?
  8. What signs or symptoms should I watch out for that may indicate a complication after the surgery?
  9. Are there any alternative treatments or procedures that could be considered instead of a total thyroidectomy for someone with Graves’ disease?
  10. What is the success rate of total thyroidectomy surgery for patients with Graves’ disease in terms of managing their condition and reducing symptoms?

Reference

Authors: Liang JJ, Irizarry R, Victor LS, Hoepner LA, Chernichenko N. Journal: Otolaryngol Head Neck Surg. 2023 Apr;168(4):754-760. doi: 10.1177/01945998221108050. Epub 2023 Jan 27. PMID: 35763358