When is the treatment of Graves' disease necessary?
One of the treatments for basedow's disease is thyroid surgery. Because this is an invasive method, which can carry certain risks, it is important to consider when to treat basedow's disease when surgery is needed for the right indication.
1. When to treat basedow's disease?
The doctor may recommend thyroid surgery to the patient basedow in the following cases:
Currently pregnant or nursing or nursing a small child at home Serious eye complications due to basedow's disease Presence Concomitant thyroid cancer or suspected malignancy As a side effect of antithyroid drugs Thyroid size is too large causing difficulty swallowing, breathing, or neck deformity Difficult to control hyperthyroidism Desire to control quickly and resolved from hyperthyroidism
2. What are the benefits of thyroid surgery?
Thyroid surgery will provide people with basedow's disease a quick and effective cure.
Although patients may need to switch from antithyroid medication to thyroid hormone supplements if the thyroid is removed, the uncomfortable symptoms are generally gone. However, patients should continue to take all anti-thyroid drugs and beta-blockers until the day of surgery. Even beta-blockers may be continued for a few days after surgery and may then be tapered off or stopped. Thyroid hormone supplementation is usually started the next day, or a few days later, in patients with poor hormone control in the preoperative period.
Since hyperthyroid surgery removes all or nearly all of the thyroid tissue from the neck, this will lead to a more rapid reduction in antibody production over time, which is beneficial for people with thyroid complications. eye. At the same time, basedow surgery also avoids the significant spike in antibody production observed with radioactive iodine treatment, which can exacerbate eye damage, especially in smokers.
For patients with significant symptoms of compression due to an enlarged thyroid gland, causing difficulty swallowing, a feeling of suffocation, shortness of breath, or neck pressure or neck heaviness, surgery for hyperthyroidism will remove some of the glandular parenchyma. thyroid and will resolve these symptoms.
For patients who want to avoid radiation exposure, thyroid surgery is a radiation-free alternative to definitive control of the disease.
3. What are the possible risks of basedow surgery?
Transient trauma to the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve leads to hoarseness, loss of voice. The risk of permanent injury is very low. Transient hypocalcaemia: At the time of surgery, the parathyroid glands, which are usually located in the posterior portion of the thyroid gland, must be carefully preserved but can still be traumatic and require a period of postoperative recovery. During this time, the parathyroid gland is unable to maintain the calcium level in the blood. At this point, proactive pre-treatment with calcium and vitamin D supplements can reduce these risks. The risk of permanent hypocalcemia due to irreversible damage to the parathyroid glands is extremely low in experienced thyroid surgeons. Bleeding, infection: The risk of these occurring in the postoperative period at the thyroid surgery site is very low. Thyroid storm: During thyroid surgery, treatment of the thyroid gland can cause a massive release of thyroid hormones into the bloodstream. If the patient has had good control of the previous history, the body is protected from the effects of this hormone. In contrast, severe thyroid storm can cause acute organ damage and sometimes even life-threatening on the operating table if not controlled immediately.
4. How to prepare for thyroid surgery?
Ensure the patient is being prescribed anti-thyroid drugs and beta-blockers for optimal control of thyroid hormone levels prior to surgery.
Surgeons should start calcium supplements before surgery basedow and supplement vitamin D if the patient is deficient.
Patients may be prescribed an iodine-reducing medication for 10 days before surgery. These iodine drops do not contain any radiation which may help reduce blood flow to the thyroid gland before surgery for hyperthyroidism.
5. How to perform thyroid surgery
Thyroid surgery will be performed under general anesthesia.
An incision is made in the front of the patient's neck so the doctor can access the thyroid gland. During surgery, the surgeon must carefully control the blood vessels to the thyroid gland, removing the thyroid gland while protecting the nerve that controls the vocal cords and parathyroid glands. If the parathyroid glands are damaged, they can be repositioned into the neck muscles so they can repair themselves.
Once the thyroid gland has been removed, the surgeon closes all layers and may leave a small duct for further drainage, removing any fluid that may have accumulated in the space where the gland is located. pre-existing armor.
The patient will be monitored for a period of time after surgery to ensure that functions are recovering well. For some patients who experience hypocalcemia after surgery, the hospital stay may be longer until the corrected calcium levels return to stable.
6. How to care after thyroid surgery like?
The type of surgery and recovery time may vary from person to person.
In general, after basedow surgery, most patients inevitably have a sore throat for a few days. Therefore, they need to be taken care of with a softer, easier-to-swallow diet during this period.
During the first week after surgery for hyperthyroidism, the patient's energy tolerance level will be lower than normal because the body is using its own energy to heal. However, when the wound improves, the patient can eat and drink gradually.
7. Do I need to continue taking medication after thyroid surgery?
Your surgeon will start thyroid hormone replacement therapy after thyroid surgery.
In most cases, the patient will have an indication to start the morning after surgery basedow . If thyroid hormone levels have not been well controlled prior to surgery or you have experienced a massive hormone release during surgery (you may notice a rapid heartbeat, high blood pressure, severe hot flashes, or tremors immediately after surgery), the surgeon may delay the medication by several days. In addition, based on calcium levels and parathyroid hormone levels in the blood, you may need calcium and/or vitamin D supplements for a period of time after thyroid surgery.
However, patients should be able to stop antithyroid drugs immediately after basedow surgery. If you're taking beta-blockers to control your heart rate, your doctor may stop, reduce your dose, or keep the same dose with your withdrawal plan for several weeks and months after surgery.
In summary, thyroid surgery is a treatment for basedow's disease with fast results, good symptom control and no risk of radiation exposure. However, for hyperthyroid surgery to bring maximum benefits, it is necessary to prepare carefully and limit unwanted risks.
For detailed advice, please come directly to Vinmec health system or register online HERE.