Risk of Complications in Patients Undergoing Complete Thyroidectomy. A Retrospective Study

  • Igli Kokalari Surgeon at Regional Hospital of Gjirokastra, Albania
  • Lila Shundi Institute of Public Health, Tirana, Albania
  • Erjona Abazaj Institute of Public Health, Tirana, Albania University Medicine, Faculty of Technical Medicine Science
  • Ela Ali Institute of Public Health, Tirana, Albania
  • Ledina Nikolla University Medicine, Faculty of Technical Medicine Science
Keywords: Thyroidectomy, complications undergoing patients, surgery

Abstract

Introduction: The main aim of this study was to determine the influence of surgery on postoperative complications in patients undergoing total thyroidectomy. Methods: Patients diagnosed with goiter and undergoing total thyroidectomy for more than ten years were retrospectively enrolled, and the main study outcomes were postoperative complications. Statistical analysis was done by chi-square and t-test with a p-value <0.05 as significant. Results A total of 116 patients with goiter were identified (mean age, 45.3 ± 8.75 years, with minimum and maximum age of 23 to 69). The most affected age with goiter resulted in 41-50 years old with 41.4% (95% CI, 37.4 to 45.8%). The majority of patients with goiter were women (85.3%), with a mean age of 47 years. After the thyroid surgery, male patients had significantly higher rates of hospital readmission than females with a risk ratio [RR] of 1.05; 95% CI [0.67–1.52], p-value = 0.02. Either hemorrhage/hematoma occurred in 4.7% and cardiopulmonary and thromboembolic events in 3.1% of the patients undergoing total thyroidectomy. In addition, either hypoparathyroidism was observed in 3.1% and temporary recurrent laryngeal nerve palsy (RLN) in 1.56%. Conclusion: The current study demonstrates that total thyroidectomy is associated with an increased rate of hemorrhagic complications. RLN palsies and hypoparathyroidism are less observed. Male patients undergoing thyroidectomy have higher rates of readmission and ICU admission. Furthermore, male patients revealed higher rates of hemorrhage and wound infection, while hypoparathyroidism or temporary recurrent laryngeal nerve palsy was more frequent among female patients.

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References

1. Haugen, BR., Alexander, EK., Bible, KC., Doherty, GM., Mandel, SJ., Nikiforov, YE., et al. (2016). 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 26, 1–133. DOI: 10.1089/thy.2015.0020
2. Ready, AR., Barnes, AD. (1994). Complications of thyroidectomy. Br. J. Surg. 81:1555-6. doi: 10.1002/bjs.1800811103.
3. Reeve, T., Thompson, N. (2000). Complications of Thyroid Surgery: How to Avoid Them, how to Manage Them, and Observations on Their Possible Effect on the Whole Patient. World J. Surg. 24, 971–975. https://doi.org/10.1007/s002680010160
4. Lukinović, J., Bilić, M. (2020). Overview of Thyroid Surgery Complications. Acta Clin Croat. 59(Suppl 1):81-86. doi:10.20471/acc.2020.59. s1.10
5. Ardito, G., Revelli, L., Polistena, A., Lucchini, R., Giustozzi, E., Guidi, ML., et al. (2016). Complications of neck dissections in papillary thyroid carcinoma: a modified procedure to reduce parathyroid morbidity. In Vivo. 30(3):303–308. PMID: 27107089.
6. Hauch, A., Al-Qurayshi, Z., Randolph, G., Kandil, E. (2014). Total thyroidectomy is associated with increased risk of complications for low- and high-volume surgeons. Ann Surg Oncol. 21(12):3844–3852. https://doi.org/10.1245/s10434-014-3846-8
7. Burge, MR., Zeise, TM., Johnsen, MW., Conway, MJ., Qualls, CR. (1998). Risks of complication following thyroidectomy. J Gen Intern Med. 1998; 13(1):24–31. doi:10.1046/j.1525-1497.1998. 00004.x
8. Sadowski, SM., Fortuny, JV., Triponez, F. (2017). A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques. 2017;6(1):30-37. DOI: 10.21037/gs.2017.
9. Shen, C., Xiang, M., Wu, H., Ma, Y., Chen, L., Cheng, L. (2013). Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury. Neural Regen Res. 8(17):1568-1575. DOI: 10.3969/j.issn.1673-5374.2013.17.004
10. Tredici, P., Grosso, E., Gibelli, B., Massaro, MA., Arrigoni, C., Tradati, N. (2011). Identification of patients at high risk for hypocalcemia after total thyroidectomy. Acta Otorhinolaryngol Ital. 31(3):144‐148.
11. Abboud, B., Sargi, Z., Akkam, M., et al. (2002). Risk factors for post thyroidectomy hypocalcemia. J Am Surg. 195:456–461. DOI: 10.1016/s1072-7515(02)01310-8.
12. Prgomet, D., Bilić, M., Kovac, L., Hutinec, Z., Topić, I. (2012). Lokalno invazivni papilarni karcinom stitnjace--nasa iskustva [Locally invasive papillary thyroid cancer--our experience]. Lijec Vjesn. 134(9-10):266-70. Croatian. PMID: 23297510.
13. Lo Gerfo, P. (1998). Local/regional anesthesia for thyroidectomy: evaluation as an outpatient procedure. Surgery. 124(6):975-8; discussion 978-9. PMID: 9854571.
14. Balentine, CJ., Sippel, RS. (2016). Outpatient Thyroidectomy: Is it Safe?.Surg Oncol Clin N Am. 25(1):61-75. doi: 10.1016/j.soc.2015.08.003
15. Lacoste, L., Gineste, D., Karayan, J., et al. (1993). Airway complications in thyroid surgery. Ann Otol Rhinol Laryngol 1993; 102:441–6. DOI: 10.1177/000348949310200607.
16. Schwartz, AE., Clark, OH., Ituarte, P., Lo Gerfo, P. (1998). Therapeutic controversy: Thyroid surgery the choice. J Clin Endocrinol Metab. 83:1097–105. doi: 10.1210/jcem.83.4.4740-1.
17. Hurtado-López, LM., Zaldivar-Ramirez, FR., Basurto, KE., et al. (2002). Causes for early reintervention after thyroidectomy. Med Sci Monit. 8: CR247–50. PMID: 11951065.
18. Abbas, G., Dubner, S., Heller, KS. (2001). Re-operation for bleeding after thyroidectomy and parathyroidectomy. Head Neck 2001;23: 544–6. DOI: 10.1002/hed.1076
19. Shaha, AR., Jaffe, BM. (1994). Practical management of post-thyroidectomy hematoma. J Surg Oncol. 57:235-8. DOI: 10.1002/ jso.2930570406.
20. Abraham, CR., Ata, A., Carsello, CB., et al. (2014). A NSQIP risk assessment for thyroid surgery based on comorbidities. J Am Coll Surg. 218:1231–7. doi: 10.1016/j.jamcollsurg.2014.01.055
21. McHenry, CR. (1997). Same-day” thyroid surgery: an analysis of safety, cost savings, and outcome. Am Surg. 3(7):586–9. PMID: 9202531.
22. Steward, DL. (2014). The pros and cons of outpatient thyroidectomy. JAMA Otolaryngol Head Neck Surg. 140:1074–6. doi: 10.1001/jamaoto.2014.2353.
23. Sahmkow, SI., Audet, N., Nadeau, S., et al. (2012). Outpatient thyroidectomy: safety and patients’ satisfaction. J Otolaryngol Head Neck Surg. 41 (suppl 1): S1–2. PMID: 22569044.
24. S⊘rensen, KR., Klug, TE. (2015). Routine outpatient thyroid surgery cannot be recommended. Dan Med J 2015;62: pii: A5016.
25. Pandey, AK., Maithani, T., Agrahari, A., Varma, A., Bansal, CH., Bhardwaj, A., et al. (2015). Postoperative Complications of Thyroid Surgery: A Corroborative Study with an Overview of Evolution of Thyroid Surgery. International Journal of Head and Neck Surgery. 6(4):149-154. DOI:105005/jp-journals-10001-1245.
26. Papaleontiou, M., Hughes, DT., Guo, C., Banerjee, M., Haymart, MR. (2017). Population-Based Assessment of Complications Following Surgery for Thyroid Cancer. J Clin Endocrinol Metab, 102(7):2543–2551. DOI: 10.1210/jc.2017-00255.
27. Narayanan, S., Arumugam, D., Mennona, S., Wang, M., Davidov, T., Trooskin, SZ. (2016). An evaluation of postoperative complications and cost after short-stay thyroid operations. Ann Surg Oncol. 23(5): 1440–1445. doi: 10.1245/s10434-015-5004-3.
28. Dehal, A., Abbas, A., Al-Tememi, M., Hussain, F., Johna, S. (2014). Impact of surgeon volume on incidence of neck hematoma after thyroid and parathyroid surgery: ten years’ analysis of nationwide in-patient sample database. Am Surg. 80(10):948–952. https://doi.org/10.1177/000313481408001008
29. Christou, N., Mathonnet, M. (2013). Complications after total thyroidectomy. J Visc Surg. 150(4):249-56. doi: 10.1016/j.jviscsurg.2013.04.003.
30. Grogan, RH., Mitmaker, EJ., Hwang, J., Gosnell, JE., Duh, QY., Clark, OH., Shen, WT. (2012). A population-based prospective cohort study of complications after thyroidectomy in the elderly. J Clin Endocrinol Metab. 97(5):1645–1653. doi: 10.1210/jc.2011-1162.
Published
2022-12-14
How to Cite
Kokalari, I., Shundi, L., Abazaj, E., Ali, E., & Nikolla, L. (2022). Risk of Complications in Patients Undergoing Complete Thyroidectomy. A Retrospective Study. European Scientific Journal, ESJ, 12, 182. Retrieved from https://eujournal.org/index.php/esj/article/view/16210
Section
ESI Preprints