Complications of Thyroid Surgery-Can We Further Minimize the Risk?

Abstract

Thyroid surgery is nowadays a mostly safe and standardized procedure, with low complication and mortality rates. The specific complications of thyroid surgery are lesion of the recurrent laryngeal nerve (RLN), hypoparathyroidism, either transient or permanent, and hemorrhage that can be in some cases life-threatening; even if not, the impact on the quality of life can be negative. The identification of risk factors for complications of thyroid surgery and development of strategies for reducing morbidity are important for the thyroid surgeon. We conducted a retrospective study on a database of 60 patients operated for a thyroid disease in a period of two years in the setting of a non-specialized general emergency hospital in both general surgery department and thoracic surgery department. The main complication was transient hypoparathyroidism (defined by lower than 8mg/dl serum calcium postoperatively)-18.33% of the group, followed by cervical minor hematoma-5.00% of cases and RLN injury in one case-1.67%. Regression analysis showed type of thyroid surgery (p-value 0.0471), histopathology type of disease (p-value 0.0566) and difficulty of surgery defined by operative time (p-value 0.0494) as the risk factors for postoperative complications, of which only the last one can be modifiable by some extent. Identifying and minimizing the risk factors of difficult surgery might improve also complication rates.