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Thyroid Lobectomy depending on the size of the nodules

  • Operating time 1-1.5 hours
  • Length of hospital stay 2-3 days
  • Calcium levels to be monitored post-operatively
1. Definition
Epithelial cells (vesicular cells), whose growth is controlled by TSH, give papillary and vesicular K.
Risk factors:

- Mostly among women
- Ionizing radiation
- Iodine deficiency

2. Diagnosis

- 90% of nodules are benign
- No action undertaken for nodules under 1 cm
- For nodules larger than 1 cm:
- TSH assay
- Thyroid ultrasound to identify the nodule
- Thyroid scintigraphy
- Hot nodules are always benign
- Cold nodules: 10% risk of cancer; cytopuncture must follow
- Cytology by biopsy
- Surgical exploration if necessary

PURPOSE: to let as little cancer through as possible

3. Surgical indication

- Family history
- Cervical irradiation history
- High Calcitonin
- Nodule > 3 cm (no involution, long-term risks of compression, unreliable cytopuncture)
- Nodule within a goitre
- Hard nodule
- Fixed nodule
- Suspicion of multiple nodules
- Compression

4. Surgical method

- Operating time: 1h
- If single nodule: thyroid lobectomy
- Advantage: no post-operative hormone therapy
- Total thyroidectomy in case of multi-nodular goitre
- Necessity of treatment with synthetic hormones (Levothyrox)

Explorative cervicotomy Duration of hospitalisation: 48 hours for a lobectomy, 72 hours for a total thyroidectomy Risks: recurrent laryngeal nerve damage resulting in bitonality; food occasionally going down the wrong way

- Recovery in 90% of cases with speech therapy sessions by a speech therapist
Risk of damaging the parathyroid glands - Consequences: hypocalcemia, which leads to a tingling feeling in the hands and feet
- Correction with calcium supplements