Working with Your Endocrinologist for the Care of Pediatric and AYA Thyroid Surgery Patients

Children, adolescents, and young adults (AYA) sometimes require surgery for thyroid problems. Thyroid cancer, which is one of the top 5 cancers among AYA between the ages of 15 and 39, is commonly treated by removing all or part of the thyroid. Thyroid cancer is also the most common endocrine cancer among children; the disease accounts for 1% of all pediatric malignancies. Thyroid surgery is also sometimes carried out to control hyperthyroidism and thyroid nodules.

Before the Surgery

Guardians of children and AYA who are about to undergo thyroid surgery are confronted with a lot of questions. The thyroid is responsible for producing hormones that play a big part in regulating a person’s metabolism and other bodily functions and processes. Parents and endocrinologists should talk about how losing this organ at an early age can affect the young patient’s future fertility, physical appearance, life-long follow up care, and how they will navigate their way around the health care system. In addition, parents should also be ready address disruptions in education and employment and whatever questions the young patient may have about mortality.

The Surgery

The surgery lasts for about 2 to 4 hours. One variation of thyroid surgery, total thyroidectomy, involves the complete removal of the thyroid gland and the surrounding lymph nodes. Another type of thyroid surgery is lobectomy or the removal of a thyroid lobe. This procedure is an option if the patient has thyroid cancer and the malignant growth has not metastasized or affected other parts of the thyroid. It can also be done to obtain samples for thyroid cancer biopsy.  The last is called subtotal or near-total thyroidectomy, a surgery that removes 1 complete lobe, the isthmus or narrow band of tissue between the lobes, and part of the other lobe. It is a treatment for hyperthyroidism caused by Graves’ disease.

After the Surgery

The patient will spend the first hour after the operation in the recovery room, and then he/she can be wheeled back to his/her hospital bed. The head of the patient’s bed will be slightly raised for the next 24 hours. Pain medication will be administered via IV at first, but the child can start taking medicines orally once he/she starts eating and drinking. The endocrinologist may order blood tests to determine calcium levels and prescribe thyroid and calcium medications. The patient can leave the hospital 1 or 2 days after the surgery.

Follow Up Care

Parents should take the patient to the hospital for a follow up with the surgeon 2 to 3 weeks after the procedure. The endocrinologist should also see the patient regularly to check and manage hypothyroidism that comes with the complete removal of the thyroid. Parents should watch out for the following signs of infection around the incision site: bleeding, fever higher than 101.5 F, redness, swelling, and yellow or green discharge. Any difficulty in breathing and swallowing, numbness around the lips or fingertips, or pain should also be brought to the doctor’s attention as soon as possible.

More Articles on Thyroid Surgery:
Thyroid Nodule Surgery
Thyroid Cancer Treatment: What the Future Holds
When is Surgery for Hyperthyroidism Recommended by Endocrinologists