Thyroidectomy: post-operative complications and management (original) (raw)
Related papers
International Journal of Head and Neck Surgery, 2015
Background To study the frequency of postoperative complications after thyroid surgery indicated for various benign and malignant lesions and to corroborate the results in relation to the extent of surgery and a clinical overview of evolution of thyroid surgery. Materials and methods An analytical study was carried out at a tertiary care center over a period of 3 years from January 2011 to December 2013. Data were collected from 80 patients who underwent thyroidectomies for various thyroid diseases at this center. Results Hemithyroidectomy, isthmusectomy, subtotal, neartotal, and total thyroidectomies were performed in 36 (45%), 6 (7.5%), 8 (10%), 10 (12.5%), and 20 (25%) cases respectively. The overall postoperative complication rate was 20%. Postoperative hypocalcemia and recurrent laryngeal nerve injury were the most common complications. Permanent hypocalcemia and permanent recurrent laryngeal nerve injury were observed in 3.75 and 2.5% of all operated cases respectively. The le...
Background: To study the frequency of postoperative complications after thyroid surgery indicated for various benign and malignant lesions and to corroborate the results in relation to the extent of surgery and a clinical overview of evolution of thyroid surgery. Materials and methods: An analytical study was carried out at a tertiary care center over a period of 3 years from January 2011 to December 2013. Data were collected from 80 patients who underwent thyroidectomies for various thyroid diseases at this center. Results: Hemithyroidectomy, isthmusectomy, subtotal, neartotal, and total thyroidectomies were performed in 36 (45%), 6 (7.5%), 8 (10%), 10 (12.5%), and 20 (25%) cases respectively. The overall postoperative complication rate was 20%. Postoperative hypocalcemia and recurrent laryngeal nerve injury were the most common complications. Permanent hypocalcemia and permanent recurrent laryngeal nerve injury were observed in 3.75 and 2.5% of all operated cases respectively. The less common complications were wound hematoma, seroma formation, and superior laryngeal nerve injury. There was no mortality observed in our series. Conclusion: The overall complication rate can be minimized by operating in a bloodless field, doing a meticulous dissection, and correctly identifying and preserving recurrent and superior laryngeal nerves along with parathyroid glands, if feasible.
Permanent complications after thyroid surgery and effect of surgeon volume
Immunopathologia Persa
Introduction: Thyroidectomy is a surgical method for the management of benign and malignant thyroid disease. Thyroidectomy may cause significant complications including hypocalcemia and recurrent laryngeal nerve injury. Permanent complications after thyroid surgery pose significant costs for healthcare system, as patients require lifelong alternative treatments and healthcare facilities. Objectives: The purpose of this study was to evaluate the incidence and risk factors for permanent complications following thyroidectomy. Patients and Methods: A total of 204 consecutive patients who underwent thyroid surgery between 2017 and 2018 were included in this prospective study. The patients were followed for 12 months after surgery and clinical and biochemical data were recorded. Results: The incidence of transient and permanent hypocalcemia was 46.8% and 6.38%, respectively. Transient hoarseness affected 30.3% of patients and 2.1% had recurrent laryngeal nerve paralysis as detected by vid...
A study of complications on thyroidectomy
Introduction: In the current era Thyroid surgeries are the most common endocrine surgeries. This procedure has been through tremendous evolution to make it a safe procedure. In spite of improved techniques, every thyroid surgeon has come across complications associated with this surgery. This study aims to understand various complications after thyroid surgeries and the factors responsible for complications and discuss management techniques for those complications in brief. Materials and Methods: 50 patients admitted in our hospital for various thyroid surgeries were followed up from pre-operative evaluation to post-operative period for appearance of complications. Those with postoperative complications were followed up and managed. Results: 12% patients had transient hypoparathyroidism, 2% had permanent hypoparathyroidism, 4% had temporary RLN palsy and 2% had permanent RLN Palsy. Other rare complications were Superior laryngeal nerve palsy, hematoma, and wound infection. Conclusion: In our study, temporary hypoparathyroidism was the most common complication (12% of the patients operated). Improved surgical techniques during thyroid surgery and efficient methods of complication management have reduced the postoperative morbidity and mortality. In spite of all measures, keen observation in postoperative period is important to look for complications for early intervention
PubMed, 2015
This prospective, cross sectional study was carried out in the Department of Otolaryngology & Head-Neck Surgery, Mymensingh Medical College Hospital, Bangladesh from August 2010 to July 2011. One hundred & twenty eight (128) patients with thyroid swelling who underwent surgery were purposely included. The study was designed to determine the incidence of recurrent laryngeal nerve injury during thyroid surgery. Among the 128 patients, female were predominant 78.90%, majority of the patient were in third decade, 96.87% patients were biochemically euthyroid. Total 5.46% patient had recurrent laryngeal nerve injury. Among them 14.28% had transient and 85.72% had permanent injury. Injury was more in total thyroidectomy done for extensive malignancy.
Complications after reoperative thyroid surgery: retrospective evaluation of 152 consecutive cases
Updates in Surgery, 2019
Reoperative thyroid surgery is an uncommon procedure that is indicated in recurrent benign or malignant disease. It is associated with a high complication rate, especially of hypoparathyroidism and recurrent nerve palsy. We retrospectively reviewed our series of patients on whom reoperative thyroid surgery was performed and we compared this group with patients who underwent primary thyroidectomies. From 2002 to 2015, 4572 thyroidectomies were performed at our institution; among these, 152 (3.3%) were for benign or malignant recurrent disease. We observed a higher rate of transient hypoparathyroidism in secondary vs primary surgery (56.6% vs 25.9%; p < 0.0001), of permanent hypoparathyroidism (10% vs 2.0%; p < 0.0001) and of transient recurrent nerve injury (4.6% vs 1.4%; p < 0.05). Reoperative thyroid surgery is a technical challenge with a high incidence of complications. Scarring, edema, and friability of the tissues together with distortion of the landmarks make reoperative surgery hazardous. Careful assessment of patient's risk factors, physical examination, and if necessary fine needle aspiration cytology are crucial for selecting the patients who should undergo reoperation. Research registry n. 2617 registered 5 June 2017 (retrospectively registered).
Objectives: Paralysis or vocal cord paresis due to iatrogenic recurrent laryngeal nerve injury (RLNI) is one of the serious problems in thyroid surgery. Recurrent laryngeal nerve (RLN) injuries represent one of the most feared complications after thyroid and parathyroid surgery. Albeit many procedures have been introduced to prevent nerve damage, the incidence of recurrent laryngeal nerve palsy ranges between 1.5-15%. The purpose of this study is to identify the risk factors for permanent and temporary recurrent laryngeal nerve injury during thyroid surgery. Place and Duration: All consecutive patients operated on at the Surgical Unit II of Ayub Teaching Hospital, Abbottabad for two years duration from May 2017 to May 2019 for thyroid surgery were reviewed. Methods: All consecutive patients who underwent thyroid surgery were admitted to the surgical ward were qualified for retrospective review. Factors predisposing to recurrent laryngeal nerve injury, such as pathology of changes and type of surgery, and identification of recurrent laryngeal nerve intra-operatively were evaluated. All patients underwent pre-operative and postoperative indirect laryngoscopic examinations. Patients with preoperative RLN injury were excluded. Vocal cord paresis was defined as a dysfunction of the vocal cord mobility compared to the contralateral one, based on postoperative fiberoptic laryngoscopy. Vocal cord palsy was defined as a total absence of movement of the vocal cord. Diagnosis of vocal cord paresis or palsy was made by the ENT specialist during the fiberoptic laryngoscopy. Results: During the study period, 680 patients underwent thyroid surgery. Their data was recorded. Transient unilateral problems with the vocal cords occurred in 22 (3.2%) cases and in 2 (0.3%) cases permanent (after Rt hemithyroidectomy). Bilateral problems with the vocal cords occurred in 4 cases (0.58%), but none became permanent. There was a significant increase in recurrent laryngeal nerve damage during secondary surgery (21.7% in secondary vs. 2.8% in primary, p=0.001), total/near total thyroidectomy (7.2% in total vs. 1.9% in subtotal, p=0.024), non-identification of RLN during surgery (7.6% in non-identification vs. 2.6% in identification, p=0.039) and in malignant disease (12.8% in malignant vs. 2.9% in benign, p=0.004). However, there was no significant difference in the frequency of recurrent laryngeal nerve damage in relation to sex (4.1% in men vs 3.8% in women, p = 0.849). Conclusion: The current study showed that thyroid cancer, recurrent goiter surgery, lack of RLN identification and total thyroidectomy were associated with a significantly increased risk of surgical recurrent laryngeal nerve damage.
The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery
Indian Journal of Surgery, 2010
Thyroid gland is an important endocrine organ because of its functions. Although the morbidity and mortality of thyroid surgery have decreased markedly, serious complications may still occur. The aim of this retrospective study was to identify the factors influencing the complications in benign nodular thyroid surgery. A total of 332 patients who underwent thyroid surgery between April 2004 and May 2008 were evaluated retrospectively to identify the factors influencing the complications. We found that in surgery lasting more than 90 minutes the risk of permanent recurrent laryngeal nerve (RLN) injury was high, daily drainage more than 50 cc increases the risk of seroma formation, retrosternal goiter surgery have higher risk for bleeding. The flap edema rates were high found in the operations made by resident surgeon and patients with size 3-4 thyroid glands. Low complication rates can be achieved after thyroidectomy with better knowledge of the surgical anatomy of the neck, thyroid pathology and required surgical treatment.
Frequency of post-operative complications of thyroidectomy
The Professional Medical Journal, 2019
Objectives: The objective of this study is to determine the frequency of post-operative complications of thyroidectomy. Study Design: Observational study. Setting: LUMHS Jamshoro at the Surgery Department. Period: January 2016 to December 2017. Material and Method: During these two years all the patients visiting surgery department with thyroid swelling were assessed. Assessment of thyroid swelling was done by detailed history and clinical examination. For further assessment of the swelling thyroid function tests (serum T3, T4, TSH level), ultrasound, isotope scanning and FNAC was performed. Assessed post-operative complications of thyroidectomy. Results: After assessment thyroidectomy was performed in 143 patients. Among them there were 37 males and 106 females. The ages of patients were in the range of 15-55 years and mean age was found to be 38 years. All of these patients have visited us due to complain of thyroid swelling. After complete assessment it was found that most commo...
A Study on Complications of Thyroid Surgery at Government General Hospital Kakinada
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Thyroid disorders are one of the most common causes of metabolic disturbances with surgery forming the main stay of treatment of thyroid swellings. Thyroid surgery in the hands of experienced surgeons is currently one of the safest procedures performed. While complications following thyroidectomy are rare, their consequences can often be debilitating and even life-threatening when they occur. This prospective study intends to assess the occurrence of various postoperative complications following different thyroidectomy procedures and the role of adequate preoperative patient preparation, careful and meticulous surgical technique and early recognition of postoperative complications with the prompt institution of treatment in reducing morbidity and providing the patient with the best chance of a satisfactory outcome. MATERIALS AND METHODS The present clinical study on complications of thyroid surgery has been made over a period of 24 months from August 2014 to August 2016 at Government General Hospital, Kakinada, utilising the cases admitted and treated in the Department of General Surgery. 441 cases were operated during this span of period (n=441), among them 55 complications were observed. RESULTS Thyroid surgeries constituted 8.3% of major surgical procedures carried out at our institution. Solitary thyroid nodule constituted most common thyroid disorder in this study forming 54% of cases followed by MNG (29%). Most of the cases were prevalent in the age group of third and fourth decade. The youngest patient of this series was 18 years and oldest was 65 years. Airway problems in postoperative period were found in 2.3% cases. Haematoma, recurrent laryngeal nerve injury and tracheal collapse secondary to the tracheomalacia were the contributory factors. In this study, 3 cases had permanent/bilateral RLN injury, tracheostomy was done. Postoperative hypocalcaemia constituted the most common complication in this study. Permanent hypocalcaemia was seen in 5 cases and were advised lifelong calcium therapy. Postoperative hypothyroidism/thyroid insufficiency occurred in 2.3% cases, which underwent total thyroidectomy. This is the second most common complication. Postoperative wound infection occurred in 1% cases. Haematoma requiring re-exploration of the neck occurred 1.1% cases, which required evacuation. Two cases of tracheal collapse following thyroidectomy were encountered. This complication although uncommon can prove fatal unless treated immediately.