Dealing with a tumor in the thorax Sometimes most of the cancerous tumor is located in the thorax, under the sternum, the breast bone. The surgeon can usually bring the thyroid up through the neck and remove it, in the process of the standard surgical procedure I outline in the “What Happens During Surgery” section. Occasionally the thyroid surgeon has to go into the chest by splitting the sternum if the mass is especially large and the surgeon can’t remove it through the neck, if the blood supply to the thyroid in the chest is especially great in the chest, or if the large mass is a cancer.
Considering a New Approach Recently, surgeons have been trying a less invasive approach to thyroid surgery called endoscopic thyroid surgery. Surgeons perform this surgery when a diagnosis of cancer is uncertain and a nodule needs to be removed. The surgeon inserts a tiny tube in the neck, and a stream of carbon dioxide gas opens up the area. The surgeon uses high magnification to see the area in excellent anatomical detail. Another tube inserted into the area has a cutting edge that allows for removal of the nodule. The result is a less unsightly scar and a quicker return to activity for most patients, although the amount of pain that patients feel is about the same as those who have a conventional operation. Endoscopic thyroid surgery may take a little longer than an open operation. If the surgeon finds cancer during the endoscopic surgery, the surgeon usually opens the neck to proceed with an open, total thyroidectomy. However, endoscopic thyroid surgery is promising as a way to avoid large scars and shorten the time between surgery and returning to work. As surgeons gain more experience with this method, it may start to replace the open operation.
Recuperating After the Operation You’ll have a permanent scar after surgery, but it may not be very visible. Most people leave the hospital the same day of the surgery if no complications develop, which is usually the case. But as I note later in this section, the possibility of hemorrhage is rare but present. You must stay in the hospital for 24 hours after surgery to deal with this complication. Don’t let the hospital staff kick you out early.
Getting back on your feet