POST THYROIDECTOMY COMPLICATIONS: THE HYDERABAD EXPERIENCE
AbstractObjective: Thyroidectomy is a very common surgical procedure worldwide and is performed bysurgeons with varied training. The outcome and complication rates are largely dependent onsurgeon’s skill and experience, the extent of surgery, indication of surgery and number of thyroidsurgeries performed at that particular centre. The objective of this study was to determine thefrequency of postoperative complications after thyroid surgery in Hyderabad, Pakistan. StudyDesign: It was a descriptive study and was carried out at 2 private hospitals including a teachingUniversity Hospital over a period of 3 years from April 2005 to March 2008. Patients andMethods: All patients with goitre, who underwent any sort of thyroid surgery, were included inthis study. Patients’ bio-data including name, age sex, clinical status of thyroid, thyroid functiontests, ultrasound, fine needle aspiration cytology and operative procedure, findings, post operativecomplications and histopathology reports were recorded. Data were analysed using SPSS 16.0.Results: The overall postoperative complication rate was 10.7%. Postoperative hypocalcaemiawas the most frequent complication observed in 3.5% of all patients followed by recurrentlaryngeal nerve (RLN) injury noted in 2.8% patients. The less common complications werebleeding, seroma formation and wound infection. Majority of these complications were associatedwith total thyroidectomy, male gender, and in patients with age more than 30 years. Conclusion:The commonest post thyroidectomy complication was hypocalcaemia. Male gender, old age, andextensive thyroid surgery were associated with increased complication rate.Keywords: thyroidectomy, hypocalcaemia, recurrent laryngeal nerve injury
Filho JG, Kowalski LP. Postoperative Complications of
Thyroidectomy for Differentiated Thyroid Carcinoma. Am J
Lombardi CP, Raffaelli M, De Crea C, Traini E, Oraganao L,
Sollazzi L et al. Complications in thyroid surgery. Minerva Chir
Robertson ML, Steward DL, Gluckman JL, Welge J. Continuous
laryngeal nerve integrity monitoring during thyroidectomy: Does
it reduce risk of injury? Otolaryngol Head neck Surg
Rosato L, Avenia N, Bernante P, DePalma M, Gulino G, Nasi
PG, et al. Complications of thyroid Surgery: analysis of a
multicentric study on 14,934 patients operated in Italy over five
years. World J Surg 2004;28:271–6.
Dionigi G, Rovera F, Boni L, Castano P, Dionigi R. Surgical site
infections after thyroidectomy. Surg Infect 2006;7 Suppl
Sadler GP. The Thyroid glands. In: Lennard TWJ (ed).
Endocrine surgery (3rd Ed). Philadelphia, PA: Elsevier Saunders,
Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M,
Dralle H. The impact of surgical technique on postoperative
hypothyroidism in bilateral Thyroid Surgery: A multivariate
analysis of 5846 consecutive cases. Surgery 2003;133:180–5.
Guraya SY, Imran A, Khalid K, Gardezi JR, Sial GA. Morbidity
of thyroidectomy. Ann King Edward Med Coll 2000;6:427–30.
Ozbas S, Kocak S, Aydintug S, Cakmak A, Demirkiran MA,
Wishart GC. Comparison of subtotal, near total and total
thyroidectomy in surgical management of multinodular goiter.
Endocr J 2005;52:199–205.
Jamil M, Amin M. Risk factors for respiratory Complications in
Thyroidectomy. J Surg Pak 2002;7:12–6.
Shah SSH, Khan A. Assessment of complications of total
thyroidectomy. J Surg Pak 2005;10: 24–6.
Dholia KR, Shaikh SA. Risks and complications of thyroid
surgery: A 10 years experience. J Surg Pak 2007;12:19–22.
Chaudhary IA, Samiullah, Masood R, Mallhi AA. Complications
of thyroid surgery: a five year experience at Fauji Foundation
Hospital. Rawalpindi. Pak J Surg 2006;22:134–7.
J Ayub Med Coll Abbottabad 2010;22(1)
Pattou F, Combermale F, Fabre S, Carnaille B, Decoulx M,
Wemeau JL, et al. Hypocalcaemia following thyroid surgery:
incidence and prediction of outcome. World J Surg
Bron LP, O’Brien CJ. Total thyroidectomy for clinically benign
disease of the thyroid gland. Br J Surg 2004;91:569–74.
Myssiorek D. Recurrent laryngeal nerve paralysis: anatomy and
etiology. Otolaryngol Clin N Am 2004;37:25–44.
Mc Henry CR. Patient volumes and complications in thyroid
surgery. Br J Surg 2002;89:821–3.
Tresallet C, Chigot JP, Menegaux F. How to prevent recurrent
laryngeal nerve palsy during thyroid surgery. Ann Chir
Sinagra DL, Montesino MR, Tacchi VA, Moreno JC, Falco
JE, Mezzadri NA, et al. Voice changes after thyroidectomy
without recurrent laryngeal nerve injury. J Am Coll Surg
Younes N, Robinson B, Delbridge L. The aetiology,
investigation and management of surgical disorders of the thyroid
gland. A NZ J Surg 1996;66:481–90.
Delbridge L, Guinea AI, Reeve TS. Total thyroidectomy for
bilateral benign multinodular goiter: effect of changing practice.
Arch Surg 1999;134:1389–93.
Chaudhary IA, Samiullah, Masood R, Majrooh MA, Mallhi AA.
Recurrent laryngeal nerve injury: an experience with 310
thyroidectomies. J Ayub Med Coll Abbattabad 2007;19:46–50.
Arif M, Ahmed I. Recurrent laryngeal nerve palsy during
thyroidectomies. J Surg Pak 2001;6:12–5.
Aytac B, Karamercan A. Recurrent laryngeal nerve injury and
preservation in thyroidectomy. Saudi Med J 2005;26:1746–9.
Chiang FY, Lee KW, Huang YF, Wang LF, Kuo WR. Risk of
vocal palsy after thyroidectomy with identification of the
recurrent laryngeal nerve. Kaohsiung J Med Sci 2004;20:431–6.
Emre AU, Cakmak GK, Tascilar O, Ucan BH, Irkorucu O,
Karakaya K, et al. complications of total thyroidectomy
performed by surgical residents versus specialist surgeons. Surg
Spear SA, Theler J, Sorensen DM. Complications after the
surgical treatment of malignant thyroid disease. Mil Med
Sitges-Sierra A, Sancho JJ. Surgical management of recurrent
and intrathoracic goiters. In: Clark OH, Duh Q-Y, Kebeben E
(eds). Textbook of Endocrine Surgery, Ch. 33. Philadelphia, PA:
Elsevier Saunders, 2005;304–17.
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