Thyroid gland

The thyroid gland is an endocrine gland, one of the most important in the human body. It is the “navigator” of the body’s metabolism or the regulatory center of metabolism. The thyroid gland through the hormones it produces controls and affects all the systems of the body.

Goitre

The thyroid gland is an endocrine gland, when it swells in size (protrudes into the throat) it causes goiter. That is, this is the abnormal swelling of the thyroid gland, the presence of which does not necessarily imply the improper functioning of the thyroid. Goiter can occur in a gland that produces large amounts of hormones (hyperthyroidism), small amounts of hormones (hypothyroidism) or the right amount of hormones (euthyroidism).

Thyroid nodule

A nodule is the growth or appearance of a tumor in the thyroid gland, which is caused by the abnormal growth and proliferation of thyroid cells. The vast majority of nodules are benign, but a small percentage of them can be malignant.

Thyroid gland control

There are three steps one can take to control one’s thyroid. First visit his doctor, who will take a detailed history and subject the patient to a thorough clinical examination. The second step is a series of blood tests. The third step is to perform imaging tests, ie an ultrasound and if further imaging is needed.

FNA puncture

It is the suction of cells through a thin needle from a thyroid nodule. They are then examined under a microscope under a microscope to determine if they are benign, malignant or suspected of being cancerous or if the material is inadequate.

FNA is not a biopsy, it is not a histological examination. It offers important information, but has the disadvantage that it examines a very small sample of cells. Therefore it cannot guarantee that there is no malignancy in the whole nodule.

Avoid the following foods

• Iodized salt
• Milk or other dairy products (ice cream, cheese, yogurt, butter)
• Vitamins or supplements containing iodine (especially seaweed)
• Seafood, including fish, shellfish, sushi, seaweed
• Foods containing the added carrageenan (carbohydrate), agar-agar (natural gelatin) alginate (colloidal polysaccharide)
• Red pigment
• Egg yolks or foods containing whole eggs
• Milk chocolate (because of the milk it contains)
• Large blackstrap (no sulfites allowed)
• Soy products (sauce, milk)

They are allowed:

• Non-iodized milk
• Albumen
• Homemade bread made with non-iodized salt and oil (not soy)
• Fresh fruits and vegetables
• Frozen vegetables
• Cereals and pasta without high iodine ingredients
• Canned fruit
• Natural unsalted nuts and nut butter
• Soda, beer, wine, fruit juices
• Coffee or tea
• Black pepper, fresh or dried herbs and spices
• Sugar, jam, jelly, honey syrup, maple

FNA puncture negative

Many times we have operated on patients whose FNA was negative. However, they had evidence of malignancy from the rest of the examination they had done and the histological diagnosis after the surgery showed malignancy. This is either because the needle did not take material from the site of the cancer, but a few millimeters next to it, or for other reasons. It should be emphasized that the FNA result is indicative.

Only a biopsy of the entire thyroid gland provides certainty about the quality of the gland. So the FNA helps a lot but the decision on whether someone will have surgery or not has to be made after all the data is taken into account.

Thyroid cancer

The thyroid gland is an endocrine gland that can be affected by cancer. This cancer is the most common endocrine cancer and usually does not cause any symptoms, it is silent. Rarely it can cause pain, “pulling” in the ear on the side that is the tumor, dysphagia or hoarseness of voice.

Questions

Thyroid cancer, at least in the early stages, usually does not cause symptoms. When it gets to the point of causing symptoms it means it has progressed. If your doctor has diagnosed you with cancer or suspected cancer, trust him or her and have surgery. If it develops and makes lymph node or distant metastases, things will become very difficult.

Surgical removal – indications

The thyroid gland needs to be treated surgically in certain cases. An indication for surgery is the presence of cancer or a strong suspicion of cancer. Also indicative are multinodular goiter and submerged goiter (thyroid in the chest). Last indication is recurrent hyperthyroidism. This happens when hyperthyroidism can not be controlled with medication (in benign conditions).

Second opinion

Many times we see that valuable time is lost, due to the fact that the patient seeks to hear what he wants, that is, that “you do not need surgery” and for this reason he seeks the opinion of many doctors. It is important and necessary to get a second and third opinion. However, it is dangerous for his health to search eagerly for a long time to hear what he wants and in the end no one to tell him, since the indication was absolute from the beginning.

That is why it is very important to be seen by a doctor who is specialized in your problem and has gained your trust over time.

Specialization experience

Thyroid surgeries, in theory, can be performed by all general surgeons. It is of course preferable to be done by a surgeon who has received special training and performs such operations on a regular basis. It is known that the rate of complications is proven to be much lower when the operation is performed by a specialized surgeon.

Postoperative scar

In terms of aesthetics, the size of the incision matters. One only has to consider one’s life with a huge incision in the neck, with a deformed scar that often extends from one ear to the other. An operation that has such an effect on the skin has a similar effect internally. In no case can it be compared with the result of an operation performed through a 2-3 cm incision that requires delicate manipulations by the surgeon.

Usually the size of the incision is inversely proportional to the surgeon’s experience, especially in the thyroid. That is, the smaller the incision, the greater the surgeon’s experience. The size of the incision is also proportional to the “thyroid residue” left after a thyroidectomy, ie the larger the incision, the larger the residue.

Thyroid residue

The thyroid gland is an endocrine gland. When treated surgically, it must be completely removed, especially in the case of cancer. So when cancer is diagnosed after a thyroidectomy, it is mandatory for the patient to have a scintigraphy. This will show the percentage of thyroid that is left in the patient (uptake) and on which his treatment depends. It will depend on how many sessions of radioactive iodine he has to do. It will also depend on the amount of radioactivity to be taken or the medication. If it is a very large residue then it will need reoperation to remove it.

Residue in our patients

In 95% of the cases of Mr. Tsirigotakis’s patients there is less than 1% residue. It is therefore easy to understand, which postoperative treatment a patient with such a residue will follow and which the patient who has 5% or even 10% thyroid residue. It is also understandable how much someone will suffer if they need reoperation. In reoperation, among other things, the rates of complications are significantly increased.

How much of the thyroid needs to be removed

The thyroid gland is an endocrine gland and if a part of it remains after surgery, it will continue to function. Acceptable thyroid surgery according to all international guidelines is almost total and ampho total thyroidectomy. The almost total is performed to minimize the complications of parathyroid or lower laryngeal nerve injury. However, if the histological examination shows the presence of cancer, the patient may need reoperation, where the rates of complications increase.

Reoperation

Reoperation causes suffering for the patient both physically and mentally as well as financially.
The operation we always perform is ampho total thyroidectomy. With this operation, whatever the outcome of the histology, our patient will not need surgery again.

The most likely complications are:

• The bleeding
• Damage to the parathyroid glands, which causes hypocalcemia
• Recurrent laryngeal injury, which can cause hoarseness

Patient safety-type of anesthesia

Our primary concern is the safety of our patient. The anesthesia required for thyroidectomy is general anesthesia. Local and intoxication are types of anesthesia that can put the patient on adventures and with them the patient is not safe. We do not need to do things to impress. The result of our operations is enough for us to impress the patient.

It is known that any type of anesthesia may need to be converted to general anesthesia during an operation. Imagine a patient being operated on in the neck area, being awake and in need of intubation urgently. This will need to be done when there is a complication. So at the time of the complication, the operation should stop, the field of the operation should stop being sterile. And the anesthesiologist should, in an emergency, intubate a patient with a complication. And all this to be done for what reason? We are not interested in the impression that endangers the safety of the patient.

You speak immediately after the surgery, you feed after 3-4 hours, you leave the next morning.

Specialization-experience

Our high expertise, our 20 years of experience and the state-of-the-art equipment we use minimize the possibility of any complication.

Back to activities

Some of our patients return the next day, others want to use their sick leave. You return to full activity, sports, swimming or hard work after 6-10 days.

Body weight

No, millions of people have undergone thyroidectomy and are taking 1 thyroxine pill daily. This perfectly regulates the body and makes the person euthyroid. This translates into absolute, orderly and normal functioning of the body.