How to choose a surgeon when considering thyroid surgery
Thyroid surgery is commonly performed in people with thyroid cancer and often in people with thyroid nodules. Surgery can also be recommended in the presence of large goitre which may obstruct the airways. The surgery is not as commonly performed for Graves’ disease. However some medical professionals believe that surgery is underused in the treatment of Graves’ disease as it provides immediate results and avoids the possible risks associated with the radioactive iodine. Surgery in case of Graves’ disease is often performed in children or adolescence with severe Graves’ disease. Other possible reasons include cases in which anti-thyroid medication is not working or is not tolerated, autoimmune thyroid eye disease and for people who refuse radioactive iodine opting for a surgical intervention. It can be an option for people for whom the radioactive treatment did not work or for women who are trying to become pregnant. Very rarely thyroid surgery may be performed in pregnant women.
Surgery is one option for Graves’ disease that a person may consider. Other options include anti-thyroid medications and radioactive iodine. There are also holistic approaches to Graves’ disease as well.
Surgery is an individual based decision and many factors need to be considered. However we have to remember that autoimmune thyroid disease is the problem of the immune system and not of the thyroid. Surgery for Graves’ disease reduces thyroid antibodies and the level of inflammation because it removes the tissue the immune system had been attacking.
Surgery is rarely performed in people with Hashimoto’s disease.
Sometimes thyroid surgery is necessary. The thyroid is not considered to be a self-regenerating organ as the cell turnover in thyroid is very slow. It is also important to aim for an optimal hormonal replacement after thyroid removal to live a good life.
The risks of thyroid surgery are generally low although there are some. I refer you to a website on the subject (1).
If you are planning a thyroid surgery, consider who will perform the operation. We choose a mechanic to fix our car, yet when it comes to a surgery, we often do not make a researched choice regarding a surgeon who will operate on us.
Here are some interesting statistics and tips to help you feel more confident when going under the knife.
The expertise of the surgeon can play a part in the rate of complications after a surgery. It is important that the surgery would be performed by a highly competent surgeon, who performs thyroid surgery routinely. Surgeons, who have performed around 500 thyroid surgeries are regarded as highly experienced. I refer you to an excellent website on the subject (2). General consensus for choosing an experienced thyroid surgeon is to ask about the number of operations the surgeon performs. Experienced thyroid surgeon performs one or more thyroid surgeries per week. Also, hospitals with an extensive experience in thyroidectomy have the lowest rates of complications. You should feel free to ask your surgeon questions regarding all of that.
I found a Canadian study (3) interesting and surprising. This study looked at 104 630 patients operated by 3314 surgeons, 774 female and 2540 male surgeons. This study talks about all types of surgeries, not just a thyroid ones. What is interesting that the study found that fewer patients treated by female surgeons died, were readmitted to hospital, or had complications within 30 days. Obviously, there seems to be more males than females in the field of operative medicine but it is still quite a surprising find. Go girl power!
- The American association of endocrine surgeons. Patients Education site. URL: http://endocrinediseases.org/thyroid/surgery_complications.shtml
- Finding a qualified thyroid surgeon. Tips for Assessing Experience and Credentials. URL: https://www.verywellhealth.com/finding-a-top-thyroid-surgeon-3233277
- Wallis CJ, Ravi B, Coburn N, Nam RK, Detsky AS, Satkunasivam R. Comparision of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. BMJ.2017 Oct 10; 359:j4366.