Thyroidectomy

Buy now to access the full article, existing subscribers login

Sections available in full article Introduction, Uses, Alternative techniques, Decision taking, Requirements, Materials required, Aftercare, Immediate Aftercare, Long term Aftercare, Sequelae, Complications, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr Andrew Gardiner BVM&S, Cert SAS, MSc, MRCVS
Dr Joe Harari MS DVM DACVS

Introduction

  • Uni- or bilateral excision  Thyroidectomy  of thyroid gland   →   using modified intracapsular technique .

Uses

  • Excision of functional thyroid adenomatous hyperplasia   →   over 90%  Thyroid gland: neoplasia  of cases of thyroid enlargement.
  • Excision of functional thyroid carcinomas   →   rare.
  • Treatment of associated hyperthyroidism  Hyperthyroidism  .

Advantages

  • Exclusion of recurrent thyrotoxicosis.
  • Definitive removal of abnormal tissue.
  • Preserves parathyroid gland   →   avoiding post-operative hypoparathyroidism  Hypothyroidism  .

Disadvantages

  • Ectopic thyroid tissue (thoracic inlet, mediastinum) can result in recurrence of hyperthyroidism (5% of cases).
  • Recurrence of hyperthyroidism due to residual nests of cells left behind with cranial capsules or tissue.

Requirements

Materials required

Minimum equipment

  • Scalpel blade no.15.
  • Fine surgical instruments:
    • Sharp-blunt surgical or straight Mayo scissors  Surgical instruments: dissecting scissors - Mayo  .
    • Self-retaining retractor (eg Weislander  Surgical instruments: self-retaining retractors - Weislander  , Gelpi).
    • Mosquito forceps  Surgical instruments: dissecting forceps - toothed   Surgical instruments: dissecting forceps - fine points  .
  • Electrocautery.

Ideal equipment

  • Electrocardiography  ECG: overview  .

Minimum consumables

  • 2 or 1.5 metric (3/0 or 4/0) multifilament synthetic absorbable suture material .
  • 2 or 1.5 metric (3/0 or 4/0) monofilament synthetic non-absorbable suture material .

Sequelae

Complications

Laryngeal paralysis
  • Damage to recurrent laryngeal nerves .
  • Signs:
    • Voice changes.
    • Airway obstruction   →   only if animal extremely agitated.
  • If unilateral, usually temporary.

Reasons for treatment failure

  • Recurrent hyperthyroidism
  • Caused by:
    • Unilateral thyroidectomy but bilateral disease.
    • Neoplastic/hyperplastic tissue in capsule remnant.
    • Neoplastic/hyperplastic ectopic tissue.

Sources

Publications

  • Padgett S (2002) Feline thyroid surgery. Vet Clin North Am Small Anim Pract. 32 (4), 851-859.
  • Padgett S L, Tobias K M, Leathers C W et al (1998) Efficacy of parathyroid gland autotransplantation in maintaining serum calcium concentrations after bilateral thyroparathyroidectomy in cats. JAAHA 34, 219-224.
  • Flanders J A (1994) Surgical therapy of the thyroid. Vet Clin North Am Small Anim Pract 24 (3), 607-621.
  • Kintzer P P (1994) Considerations in the treatment of feline hyperthyroidism. Vet Clin North Am Small Anim Pract 24 (3), 577-585.
  • Birchard S J (1991) Thyroidectomy and parathyroidectomy in the dog and cat. Probl Vet Med 3 (2), 277-289.
  • Welches C D et al (1989) Occurrence of problems after three techniques of bilateral thyroidectomy in cats. Vet Surg 18 (5), 392-396.
  • Flanders J A et al (1988) Feline thyroidectomy - a comparison of post-operative hypocalcaemia associated with three different surgical techniques. Vet Surg 17 (2), 59.
  • Flanders J A et al (1987) Feline thyroidectomy - a comparison of post-operative hypocalcaemia associated with three different surgical techniques. Vet Surg 16 (5), 362-366.

Sample content only, to unlock the full article login or buy now

Loading...