Thyroid Health

Why Might Thyroid Nodules Need To Be Surgically Removed?

Thyroid nodules can be diagnosed as two primary forms, malignant (cancerous) or benign (non-cancerous). This diagnosis is one of the most significant factors considered before a suitable method of treatment is prescribed.

Is it necessary to surgically remove thyroid nodules?

According to the American Thyroid Association (ATA), over 80% of thyroid nodules are non-cancerous (benign)2. Typically, non-cancerous nodules do not need any interventions unless they are symptomatic or causing cosmetic issues. These symptoms can include difficulty breathing or swallowing and pressure in the neck. Benign thyroid condition can be treated without surgery using conservative treatment or minimally invasive options such as Radiofrequency Ablation (RFA) or Percutaneous Ethanol Ablation (PEI)5.Surgical removal of the benign nodule might also be suggested by your doctor, depending on the size or tissue composition. Regardless of which treatment option you choose, continuous checkups will be necessary to ensure the condition is not recurring.

Malignancy (cancer) is the primary indication for surgical removal of the thyroid gland. Fortunately, most thyroid cancers respond well to treatment, with a low mortality rate of 4%-8% in 20 years7. Common indications for surgery include:

  • A nodule that is highly suspicious for cancer
  • A diagnosis of thyroid cancer
  • Symptomatic nodule or goiter – compression of the trachea (windpipe), difficulty swallowing, a visible or unsightly mass
  • Thyrotoxicosis caused by an Autonomously Functioning Thyroid Nodule (AFTN) overproducing thyroid hormones

If your thyroid nodule meets any of these above conditions, your doctor may recommend thyroid surgery.

Types of Thyroid Surgery:

  • Hemithyroidectomy: This involves removing one lobe of the thyroid. A doctor may recommend this surgery if a nodule or low-risk thyroid cancer is limited to one side of the thyroid1
  • Lobectomy: This involves the removal of one lobe and the isthmus (bridging tissue between the two lobes of the thyroid gland)
  • Isthmusectomy: This surgery removes the isthmus. Small tumors on the isthmus may only require an isthmusectomy.
  • Total thyroidectomy: This involves removing the entire thyroid gland. Some cases of thyroid cancer, bilateral thyroid nodules, and Graves’ disease require a total thyroidectomy.

Not all thyroid conditions can be treated conservatively. Some conditions need surgical removal, while others can be treated minimally invasively. Knowing your condition through the right diagnosis will help you make the right decision for your thyroid issues. Have questions about your thyroid nodules? Speak to a specialist today to explore your options.

Thyroid Gland Removal: Procedure, Risks, and Aftercare. Retrieved January 23, 2021, from https://www.healthline.com/health/thyroid-gland-removal

Thyroid Nodules | American Thyroid Association. American Thyroid Association. Retrieved January 23, 2021, from https://www.thyroid.org/thyroid-nodules/

Thyroid Nodule: Causes, Signs, Symptoms, Diagnosis & Treatment. Cleveland Clinic. Retrieved January 23, 2021, from https://my.clevelandclinic.org/health/diseases/13121-thyroid-nodule

Thyroid Nodules. Retrieved January 23, 2021, from http://www.thyroid.org/wp-content/uploads/patients/brochures/Nodules_brochure.pdf

RFA For Life: Treatment of Benign Thyroid Nodules. RFA for Life. Retrieved January 23, 2021, from https://rfaforlife.com/

R. Gervasi, G. Orlando, M. A. Lerose, et al., “Thyroid surgery in geriatric patients: a literature review,” BMC Surgery, vol. 12, no. 1, article no. S16, 2012.

Rumack, C. M., Wilson, S. R., & Charboneau, J. W. (2005). Diagnostic ultrasound. St. Louis: Elsevier Mosby.

Thyroid Radiofrequency Ablation (RFA) For Thyroid Nodules. (n.d.). Retrieved January 27, 2021, from https://seannikravanmd.com/thyroid-radiofrequency-ablation-rfa/

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Indication
The VIVA Combo RF Ablation System and star RF Electrode are intended for use in percutaneous and intraoperative coagulation and ablation of tissue.

Contraindications
There is a risk that error may result due to the radiofrequency current on patients who have pacemakers and other active implants. Do not use the radiofrequency lesion generator and electrode on these patients.
Complications:
The following types of complications may result due to the use of the radiofrequency lesion generator and electrode.
– Tumor recurrence
– Burn due to the over-heating of the the surgical equipment
– Dangerous situation due to the unskilled equipment control
– Cross-infection or complications due to the re-use of the inappropriate electrode
– Ascites/diarrhea
– Bleeding of the coagulated part
– Ventricular fibrillation
– Weakness of liver functions
– Symptoms after RFA treatment includes (abdominal) pain, fever, nausea, headache, right shoulder joint pain and chest discomfort might occur

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