Thyroid gland surgery is not performed immediately. Aram Chomoyan
16 October 2019 | News | Endocrinology | Aram S. Chomoyan
In Armenia, as in an endemic zone of iodine deficiency, there are various types of thyroid diseases that are widely spread. Taking into account the improvement of the possibilities of diagnostic methods in recent years and the increase of Armenian population's referrals to the medical centers, there is a growth in the total number of thyroid diseases. Recently, patients that undergone urgent surgery for thyroid disease have become more common. The answers to those and other frequently asked questions are below.
In which cases is it necessary to operate?
Firstly, operation is needed in case of cancer. Large benign nodules (4 cm and more) or notably enlarged gland are in the second place. Persistent hyperthyroidism (so-called toxic goiter) is in the third place. In this case, surgical treatment is performed only when all the other methods have been depleted.
Apart from surgical treatment, what other methods are there?
First of all medication is prescribed. If it is not effective, the thyroid gland radiation with radioactive iodine is performed. If radiation with radioactive iodine is contraindicated or ineffective, only after that surgical treatment is performed.
What surgical methods are used?
Radical surgeries are now preferred in leading countries. Depending on the situation, they may be different. Hemithyroidectomy (removal of the half of the gland), thyroidectomy (complete removal of the gland), thyroidectomy + lymphadenectomy (complete removal of the gland with the removal of lymph nodes).
How do you choose the surgery type?
The volume of the planned surgery is determined by the surgeon. The stage of the disease is accessed previously, then based on the modern guidelines an optimal surgical volume for a particular case is selected.
As an example. There is toxic goiter and non-surgical treatment methods are not effective, so the endocrinologist suggests surgical treatment.
What is needed to do in such cases?
Such patients require special attention and preparation. Surgery should be performed on the background of normal or near-normal range of thyroid function.
What if the operation is urgent?
It cannot be done urgently.
How is thyroid cancer diagnosed?
The best and the irreplaceable diagnostic method for thyroid cancer which is available till today is the fine needle aspiration (FNA) biopsy.
Are there any alternative examination methods?
None. The only alternative may be the determination of calcitonin in the blood, which, however, can only be informative in the case of rare medullary cancers.
If the puncture detects cancer, do they offer an urgent surgery?
No, thyroid surgeries cannot be urgent, but only planned. At the same time, it does not mean that the patient that is diagnosed with cancer can have the surgery after several months or years. Everything should be done within a reasonable time and without panic. It should be noticed that as a rule, thyroid surgeries are planned in case of any diagnosis, so it can never be urgent.
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