Prospective Study of Complications Following Surgery for Thyroid Malignancy: A Tertiary Cancer Care Centre Experience (original) (raw)

Postoperative complications of thyroidectomy for differentiated thyroid carcinoma

American Journal of Otolaryngology, 2004

Objective: This study evaluates the incidence and risk factors of complications in patients submitted to thyroidectomy for differentiated thyroid carcinoma in a cancer hospital with residency training. Study Design: A retrospective chart and complications review of 316 consecutive patients who underwent thyroidectomy for differentiated thyroid carcinoma. Results: Of the 316 patients, the main postoperative complications were transient hypocalcemia in 87 (27.5%), permanent hypocalcemia in 16 (5.1%), transient vocal cord palsy in 4 (1.2%), and permanent vocal cord palsy in 2 (0.6%). Neck dissection and paratracheal lymph node dissection when associated with total thyroidectomy were significantly related to transitory and permanent hypocalcemia. Conclusion: Thyroid surgery can be performed safely in a hospital with medical residency training program under direct supervision of an experienced surgeon with acceptable morbidity. Hypocalcemia is the most significant complication. Neck and paratracheal lymph node dissections were the most significant predictors of hypocalcemia in patients submitted to total thyroidectomy. (Am J Otolaryngol 2004;25:225-230.

POST-OPERATIVE COMPLICATIONS AFTER THYROIDECTOMY FOR DIFFERENTIATED THYROID CARCINOMA

Introduction: The purpose of this study is to assess the percentage and risk factors for thyroid cancer complications in thyroid patients. Study design: case series. Place and duration: In the Surgical Unit II and ENT department of Services Hospital Lahore for one year duration from February 2019 to February 2020. Method: Retrospective review of complications of 50 consecutive thyroid patients due to differentiated thyroid cancer was done in this study. Retrospective evaluation of postoperative complications was performed in fifty patients (various surgical procedures) who underwent thyroid due to differentiated thyroid cancer. Result: Hypocalcaemia in 16 patients (32%) and transient vocal cord paralysis in one patient (2%) were serious postoperative complications in fifty patients. Along with the total thyroid, excision of the tracheal lymph nodes was significantly associated with temporary and permanent hypocalcaemia. Conclusion: Thyroid surgery can be performed safely with acceptable morbidity. Hypocalcaemia is the most important complication. The dissection of the tracheal lymph nodes was the most important predictor of hypocalcaemia in patients who received complete thyroid.

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

Post-operative complications after completion thyroidectomy for differentiated thyroid cancer

European Journal of Surgical Oncology (EJSO), 1997

The surgical approach to differentiated thyroid carcinoma is still controversial, as many authors consider it necessary to remove the whole gland. Therefore, when definitive histological diagnosis is made following limited resection, reoperation and completion thyroidectomy (CT) is sometimes recommended. The main indications are for follicular cancer or for patients with a carcinoma of >/! cm previously treated with Iobectomy or limited resection (early CT), or for local recurrence after previous treatment (late CT). Several authors, however, draw attention to the high rate of complications following completion thyroidectomy and advocate its use in more limited circumstances. The aim of the study was to evaluate the results of our experience with CT in the National Cancer Institute in Naples. Of 131 patients treated for thyroid cancer 35 (26.7%) underwent a CT. Re-operation was performed within 6 months in 26 cases (74.3%) and later in the remaining nine cases (25.7%) : carcinoma in the residual gland was found in six cases (23%) of early CT, and in four cases (45%) in the late CT group with an overall incidence of 28.5%. Post-operative complications were: transient hypoparathyroidism, two cases (5.6%), permanent in one (2.8%). Transient recurrent laryngeal nerve palsy occurred in three patients (8.5%) and became permanent in one case (2.8%). Completion thyroidectomy can therefore be considered a safe procedure.

Surgical complications after thyroid surgery performed in a cancer hospital

Otolaryngology - Head and Neck Surgery, 2005

OBJECTIVE: This study evaluates the incidence and risk factors of complications in patients submitted to thyroidectomy in a cancer hospital with residency training. STUDY DESIGN: A retrospective chart and complications review of 1020 patients (1990-2000) underwent to thyroidectomy. RESULTS: At our cancer hospital, 1020 patients underwent thyroidectomy. The main postoperative complications consisted of transient hypocalcemia in 134 (13.1%) patients, permanent hypocalcemia in 26 (2.5%) patients, transient vocal cord palsy in 14 (1.4%) patients, and permanent vocal cord palsy in 4 (0.4%) patients. The type of thyroidectomy, neck dissection, and paratracheal lymph node dissection were significantly associated with transitory and permanent hypocalcemia. CONCLUSION: Thyroid surgery can be performed safely in a surgical residency training program under direct supervision of an experienced surgeon with little morbidity to the patients. Hypocalcemia is the most significant complication. Neck and paratracheal lymph node dissections were the most significant predictors of hypocalcemia in patients who underwent total thyroidectomy.

Complications in primary and completed thyroidectomy

Surgery Today, 2010

To compare the rates of postsurgical complications following a primary and completed thyroidectomy for multinodular goiter (MNG). A total of 7123 cases of thyroidectomy in two hospitals from 1990 to 2007 (n = 3834 [53.83%] total [TT], n = 2238 [31.42%] subtotal [ST], and n = 1051 [14.75%] hemithyroidectomy [HT]) were studied for complications. The follow-up checked for injury of the laryngeal nerves, hypoparathyroidism, pathology recurrence, and appearance of neoplasm. Postoperative mean follow-up: 7 years 9 months Primary operation: permanent recurrent laryngeal nerve (RLN) injury was observed in 1.4% in the TT group, 1.2% in the ST, and 0.9% in the HT group (P > 0.1 vs ST and TT). Permanent hypocalcaemia: 3.5% in TT group, 2.5% in the ST, in 1.4% in the HT. Eight hundred and seventy-seven patients suffered recurrence of MNG (n = 482 after ST, n = 395 after HT). Five hundred and sixty-four recurrent cases required a completion thyroidectomy. Reoperations: Permanent RLN injury was observed in 3% in the post-ST group and 2.5% in the post-HT group. Permanent hypocalcemia: 5.9% in the post-ST group and 4% in the post-HT group. There is no significant difference in complications between a primary TT and ST. The rates of complications after a completed thyroidectomy are significantly higher in comparison with the primary operations. High rates of reoperation in cases of recurrent pathology and incidental carcinoma were reported.

Assessment of the Morbidity and Complications of Total Thyroidectomy

Archives of Otolaryngology-head & Neck Surgery, 2002

Cross-sectional analysis of a national database on total thyroidectomy cases. Methods: The National Hospital Data Survey database was examined and all cases of total thyroidectomy performed during 1995 to 1999 were extracted. In addition to demographic information, postoperative complications including hypocalcemia, recurrent laryngeal nerve paralysis, wound complications, and medical morbidities were identified. Statistical analysis was conducted to determine potential predictive factors for postoperative complications. Results: A total of 517 patients were identified (mean age, 48.3 years). The most common indications for total thyroidectomy were thyroid malignancy and goiter (73.9% of cases). Eighty-one patients (15.7%) underwent an associated nodal dissection along with total thyroid-ectomy, and 16 patients (3.1%) underwent parathyroid reimplantation. The mean length of stay was 2.5 days (95% confidence interval, 2.3-2.8 days). The incidence of postoperative wound hematoma was 1.0%, wound infection was 0.2%, and mortality rate was 0.2%. The incidence of postoperative hypocalcemia was 6.2%. Younger age was statistically associated with an increased incidence of hypocalcemia (P=.002, t test), whereas sex (P=.48), indication for surgery (P=.32), parathyroid reimplantation (PϾ.99), and associated neck dissection (P=.21) were not. The mean length of stay was 2.5 days and was unaffected by occurrence of postoperative hypocalcemia. The incidences of unilateral and bilateral vocal cord paralyses were 0.77% and 0.39%, respectively. Conclusions: Postoperative hypocalcemia is the most common immediate surgical complication of total thyroidectomy. Other complications, including recurrent laryngeal nerve paralysis, can be expected at rates approximating 1%.

Thyroidectomy: post-operative complications and management

International Surgery Journal

Background: Thyroidectomy is a surgical procedure indicated as elective treatment for symptomatic thyroid swellings or neoplasms. Today most of the complications of thyroid surgery are related to either metabolic derangements or injury to the recurrent laryngeal nerve injury. Other complications include superior laryngeal nerve injury, infection, airway compromise, and bleeding. Hence, before any thyroid surgery patient must be precisely informed the possible complications and their remedies. The present study aims to evaluate post-operative complications after thyroid surgery.Methods: In a tertiary care hospital based longitudinal study patients presenting with clinically and sonographically diagnosed thyroid swelling who underwent surgical intervention were enrolled in the study. These patients were evaluated for thyroid profile test, fine needle aspiration cytology (FNAC), pre-operative and post-operative indirect laryngoscopy, serum calcium level and histopathology. Intra operat...

Local complications after surgical resection for thyroid carcinoma

The American Journal of Surgery, 1994

BACKGROUND: One of the issues in the debate surrounding the extent of thyroid excision for localiTed, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection. This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer.