Thyroid surgery
Thyroid surgery is the most common endocrine operation. Based on the size and the cause of the thyroid enlargement (i.e. cancerous or not) some patients have only half of the thyroid removed (thyroid lobectomy) while others need the entire thyroid gland removed (total thyroidectomy).
Indications for thyroid lobectomy
large bening nodule with compressive symptoms
suspicious thyroid nodules (THY3-4 cytology)
thyroid cancer < 4cm (and no lymph nodes).
Indications for total thyroidectomy
Graves disease
large multi nodular goiters
thyroid cancer > 4cm
thyroid cancer associated with palpable lymph nodes
prophylactic surgery in patients with MEN-2 syndrome
Expertise for complex thyroid surgery
I have a large extraterritorial referral pattern based on interest and expertise provided in the care of patients with more advanced conditions:
large retrosternal goiters
locally advanced thyroid cancer needing central lymph node dissection or modified functional radical neck dissection.
patients presenting with vocal cord palsy
paediatric cases
familial conditions (MEN-2 and Cowden syndrome)
All new patients with thyroid cancer are discussed in a multidisciplinary meeting that includes consultants in oncology, pathology and endocrinology.
Building on the clinical expertise accumulated to date I contributed to the national guidelines for management of thyroid cancer on behalf of British Association of Head Neck Oncology (BAHNO) (paper published) and I am currently part of the working group for Management of Thyroid Cancer, 6th Edition, Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines.