Isthmusectomy: Purpose, Benefits, Side Effects, and Procedure
An isthmusectomy is a procedure to treat thyroid tumors in the center of your thyroid gland. It preserves more of your thyroid tissue than more invasive procedures.
An isthmusectomy is a type of thyroid gland surgery that removes the bridge between the left and right lobes of your thyroid gland. Surgeons use it to treat small tumors in the central part of your thyroid gland, which is called the isthmus.
Doctors sometimes recommend an isthmusectomy over more extensive procedures to minimize the side effects of thyroid surgery.
Read on to learn more about isthmusectomy, including when a doctor may suggest it, its effectiveness, and potential side effects.
Thyroid isthmusectomy purpose
The purpose of an isthmusectomy is to treat small tumors in the area between the two lobes of your thyroid gland. This area is called the isthmus. A surgeon may combine it with a partial thyroidectomy to remove the center of your thyroid and either the left or right lobe.
Isthmusectomy side effects and risks
Like all surgeries, isthmusectomy comes with a risk of side effects. The main side effects include:
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- bleeding
- injury to the nerves that help you speak
- injury to your parathyroid glands
Because a surgeon removes only a small part of the thyroid gland during an isthmusectomy, there’s a smaller chance of needing to take replacement hormones than with more invasive thyroid surgeries.
Even people who have a partial thyroidectomy, where a surgeon removes half the thyroid gland, don’t usually need to take replacement hormones.
According to the American Thyroid Association, 80% of people who have a partial thyroidectomy don’t need to take medications unless they’re already taking them for low thyroid levels.
How effective is isthmusectomy?
The most common type of thyroid cancer is papillary carcinoma. According to a 2022 study, about 1% to 9.2% of these cancers arise in the isthmus.
The role of isthmusectomy in the management of papillary carcinoma is controversial since there’s limited research comparing its effectiveness with other procedures.
In the same 2022 study, researchers examined the outcomes of 65 people who had an isthmusectomy to treat solitary papillary thyroid tumors in China between 1985 and 2015. Two people experienced recurrence in the median follow-up period of 78 months. The 10-year overall survival was 98.3%, and the 10-year disease-specific survival was 100%.
In a 2020 study, researchers found that isthusectomy may be effective in treating well-differentiated thyroid carcinoma in selected people with features of nonaggressive cancer.
Isthmusectomy steps
Here’s a general idea of what to expect before, during, and after a thyroid surgery.
Before the procedure
You’ll receive a general anesthetic before your procedure to put you to sleep. You’ll receive the anesthetic through a mask on your face or through a medication injected into a vein, often in your hand or wrist.
Once you’re unconscious, you’ll receive a breathing tube, and a healthcare professional will connect you to monitors to check your vitals.
During the procedure
Once you’re unconscious, your surgeon will:
- Make an incision across the front of your neck, above your collarbone.
- Locate important structures around your thyroid gland, like nerves and your parathyroid glands, to avoid damaging them during your procedure.
- Detach the central part of your thyroid gland and remove it.
- Close your wounds with stitches.
After the procedure
You’ll wake up after your surgery in a recovery room, where your healthcare professional will monitor you for complications. You may have a drain in your neck to help drain your wound. You’ll likely be able to eat and drink shortly after your surgery.
Preparing for isthmusectomy
Your surgical team can give you specific instructions on how to prepare for your procedure.
If you’re receiving a general anesthetic, you’ll need to stop eating and drinking hours before. You may also need to stop taking certain medications or supplements that thin your blood.
Recovering from isthmusectomy
Following your surgical team’s instructions gives you the best chance of recovering quickly without complications.
You might have swelling around your wound for up to 6 days after your procedure, according to the National Health Service (NHS) of the United Kingdom.
The NHS also suggests that you won’t be able to drive for at least 2 weeks after your procedure, and most people need up to 2 weeks to return to work.
Isthmusectomy recovery time
Everybody’s recovery process is different, but here’s a general idea of the typical recovery timeline:
- During the week after your procedure, you can start doing light activities, like cooking and walking around the house.
- In your second week, you can go for longer walks, and you may be able to start jogging for 15 to 30 minutes at a time.
- In your second to fourth weeks, you may be able to start doing more strenuous activities, like picking up weight up to 11 pounds.
- By 6 weeks, most people can gradually return to their normal activities.
Are there any alternatives to isthmusectomy?
Alternative surgeries for thyroid tumors include:
- Lobectomy: A lobectomy is a procedure to remove one side or lobe of your thyroid gland. It’s also called a hemi-thyroidectomy or a partial thyroidectomy.
- Near-total thyroidectomy: A near-total thyroidectomy is surgery to remove most of the thyroid gland, but it leaves a little so that your body can still produce some thyroid hormone.
- Total thyroidectomy: A total thyroidectomy is a procedure to remove your entire thyroid gland. It’s the most common surgery for thyroid cancer.
- Neck dissection: Surgeons do neck dissection to remove lymph nodes and tissue from your neck. They may combine it with a thyroidectomy.
How much does isthmusectomy cost?
The cost of your procedure can vary depending on factors like:
- your insurance coverage
- where you live
- the extent of your procedure
For reference, the nonprofit FairHealth estimates that 80% of procedures to remove a thyroid gland lobe in Buffalo, New York, cost less than $4,535 without insurance.
There might also be other costs, such as $13,511 for outpatient hospital fees or $2,040 for the anesthetic.
Frequently asked questions about isthmusectomy
Here are some frequently asked questions people have about isthmusectomy.
What is the isthmus of the thyroid gland?
The isthmus is the central part of your thyroid gland, between the left and right lobes.
Is the isthmus removed in thyroidectomy?
Surgeons often combine isthmusectomy with a partial thyroidectomy to remove the center and one lobe of your thyroid.
What happens when the thyroid is removed?
If a surgeon removes your entire thyroid gland, you’ll need to take medications to replace the thyroid hormone this gland normally produces. You may not have to take medications if your surgeon only removes part of your thyroid gland.
What is an Isthmusectomy?
An isthmusectomy is a surgical procedure that involves the removal of the isthmus of the thyroid gland. It is often performed to treat specific thyroid conditions.
What is the Purpose of an Isthmusectomy?
The primary purpose of an isthmusectomy is to remove thyroid nodules, benign tumors, or low-risk cancer localized in the isthmus of the thyroid gland. It can also be performed to alleviate symptoms associated with thyroid disorders.
What are the Benefits of an Isthmusectomy?
Benefits of an isthmusectomy include symptom relief from thyroid disorders, improved thyroid function, and a lower risk of complications associated with larger thyroid surgeries. It is less invasive than a total thyroidectomy.
What are the Side Effects of an Isthmusectomy?
Possible side effects of an isthmusectomy may include hoarseness, bleeding, or infection. These are generally mild and manageable compared to more extensive thyroid surgeries.
How is the Isthmusectomy Procedure Performed?
The isthmusectomy procedure is performed under general anesthesia. A small incision is made in the neck to access and remove the isthmus of the thyroid gland. The surgery is typically completed in a few hours, with most patients able to return home later the same day or the next.
Is an Isthmusectomy a Major Surgery?
Compared to other thyroid surgeries, an isthmusectomy is considered less invasive. It is a focused procedure that involves removing only a portion of the thyroid, typically resulting in a shorter recovery time.
What is the Recovery Time After an Isthmusectomy?
Recovery time from an isthmusectomy is generally short. Most patients can return to normal activities within a week. However, specific recovery experiences may vary based on individual health conditions.
Are there any Alternatives to an Isthmusectomy?
Alternatives to an isthmusectomy could include medication management or other surgical options like a hemithyroidectomy, depending on the condition being treated. Consulting with a healthcare provider is crucial to determine the best treatment option.
When Should You Consider an Isthmusectomy?
Consideration for an isthmusectomy should be given if diagnosed with a thyroid condition affecting the isthmus, where other treatments have not been effective, or if there’s a need to remove suspect nodules or growths.
These FAQs provide a clear, straightforward overview of the isthmusectomy procedure, optimized for search engine visibility and easy understanding.
What is an Isthmusectomy?
An isthmusectomy is a surgical procedure involving the removal of the thyroid isthmus, the thin band of tissue connecting the two lobes of the thyroid gland.
What is the Purpose of an Isthmusectomy?
The primary purpose of an isthmusectomy is to treat thyroid nodules or tumors located specifically in the isthmus area. It may also be performed to diagnose or manage certain conditions affecting the thyroid gland.
What are the Benefits of an Isthmusectomy?
The benefits of an isthmusectomy include precise removal of problematic nodules, potentially reducing the need for more extensive thyroid surgery. It can help in accurately diagnosing thyroid conditions and minimizing complications.
What are the Possible Side Effects of an Isthmusectomy?
Possible side effects include bleeding, infection, voice changes, and issues with calcium levels if the parathyroid glands are affected. Most patients recover without significant complications.
How is the Isthmusectomy Procedure Performed?
The procedure involves making a small incision in the neck, through which the targeted portion of the thyroid is removed. It is typically done under general anesthesia and may involve a short hospital stay.
Is an Isthmusectomy a Common Procedure?
An isthmusectomy is less common than other thyroid surgeries, as it is specific to cases where the problem is isolated to the isthmus of the thyroid gland.
Who is a Good Candidate for an Isthmusectomy?
A good candidate for an isthmusectomy is someone with thyroid nodules or tumors confined to the isthmus who requires surgical intervention to alleviate symptoms or for diagnostic purposes.
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An isthmusectomy preserves more of your thyroid tissue than more invasive procedures, like a partial or a total thyroidectomy.
Your doctor is most likely to recommend an isthmusectomy for small tumors that are unlikely to be aggressive. They can advise you about whether you’re a candidate for an isthmusectomy.
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