A study on the postoperative complications associated with thyroid surgery

Abstract

This retrospective study included 182 patients who underwent surgery for thyroid disease between September 2016 and March 2022 at our hospital. The age, sex, histology (benign disease, malignant tumor, Basedow's disease), surgical procedure (hemithyroidectomy, total thyroidectomy, neck dissection), and postoperative complications (postoperative bleeding, hypoparathyroidism, vocal cord paralysis, lymphorrhea) were evaluated. Among the 182 patients, the incidence of postoperative complications was 3.3% for postoperative bleeding, 19.8% for hypoparathyroidism (including transient), 8.2% for vocal cord paralysis, and 1.6% for lymphorrhea. In particular, postoperative bleeding was observed in malignant tumors and Basedow's disease and was more frequent in total thyroidectomy cases than benign disease. Hypoparathyroidism was more frequent in patients with Basedow's disease than benign disease and malignant tumors, and it was also more frequent in patients who underwent total thyroidectomy than in those who underwent hemithyroidectomy and neck dissection . This is considered to be the result of total thyroidectomy in all cases of Basedow's disease. In addition, although the risk of vocal cord paralysis is high in malignant tumors and Basedow's disease, all cases of benign disease improve within 6 months, and 70% of malignant tumors improved within 1 year. Cases of lymphatic dissection near the thoracic duct are considered to be at a high risk of lymphorrhea. A sufficient preoperative explanation and careful surgical procedures are required, especially in cases in which preoperative malignancy is suspected.