Thyroid Surgery in Istanbul: Complete Guide for International Patients

Thyroid surgery is performed in different scopes depending on the nature of the pathology. Total thyroidectomy is the removal of the entire thyroid gland; it is preferred in thyroid cancer, bilateral multinodular goitre and Graves' disease. Lobectomy (hemothyroidectomy) is the removal of a single thyroid lobe; it is generally performed for unilateral suspicious nodules.

Isthmus resection is sufficient for isolated isthmus nodules. Subtotal thyroidectomy is less frequently chosen today, removing most of the gland while leaving a small amount of tissue. Each technique has a different advantage and risk profile; the choice is made based on the patient's diagnosis, nodule characteristics and surgeon experience.

The recurrent laryngeal nerve (RLN) passes immediately behind the thyroid gland and controls the vocal cords. The most important risk of thyroidectomy is damage to this nerve, which can lead to permanent voice change. Continuous intraoperative neuromonitoring (CIONM) allows the surgeon to monitor this nerve electrophysiologically throughout surgery and the risk is markedly reduced.

At experienced centres the rate of permanent RLN injury is below 0.5-1%. Temporary voice change is more common and resolves spontaneously in the great majority within 4-8 weeks. Preservation of the parathyroid glands is equally critical; experienced surgeons preserve parathyroid glands in-situ during thyroidectomy or perform autotransplantation when necessary.

The hospital stay after thyroidectomy is generally 1-2 nights. During this period calcium levels are monitored; if signs of temporary hypoparathyroidism (numbness, tingling) appear, calcium and vitamin D supplementation is given. At discharge the neck incision is typically small and carefully closed; with good scar care it fades over time.

After total thyroidectomy lifelong thyroid hormone replacement therapy (levothyroxine) is required. After lobectomy, adequate thyroid function may remain; this varies from person to person. Endocrinology follow-up is critically important for planning.

The international patient protocol at Istanbul's academic centres includes: pre-operative virtual consultation, coordination of required imaging investigations, surgery, post-operative care and a coordinated discharge plan with your local doctor. Pathology results are generally ready 5-7 business days after surgery and reports are transmitted digitally.

Ideally a 4-5 night stay in Istanbul should be planned after total thyroidectomy. Waiting at least 5-7 days after surgery before flying is recommended. If calcium levels are stable and the incision is uncomplicated, travel is appropriate.