Risk factor of thyroid surgery complications

Czech version

Authors: B. Uhliarová ¹; G. Bugová ²; A. Hajtman ²
Authors‘ workplace: Oddelenie otorinolaryngológie, FNsP FD Roosevelta, Banská Bystrica ¹; Klinika otorinolaryngológie a chirurgie hlavy a krku, UK JLF a UNM, Martin ²
Published in: Otorinolaryngol Foniatr, 69, 2020, No. 1, pp. 17-23.
Category: Original Article

Overview

Objective: Thyroid surgery is a relatively safe operation, but there is still a risk of complications that may have permanent consequences for the patient. The aim of this work was to determine the risk factors for complications of thyroid surgery.

Material and methods: In the retrospective study, 1960 adult patients who underwent total thyroidectomy or hemithyroidectomy at the Department of Otorhinolaryngology and Head and Neck Surgery JLF UK and UNM in Martin between 2005-2014 were analyzed. The incidence of complications of thyroid surgery - recurrent nerve damage (NLR), hypocalcaemia, hypoparathyroidism and post-operative bleeding was evaluated. The risk factors of complications of thyroid surgery - age, sex, indications of surgery, malignancy, volume of thyroid gland, retrosternal goiter and type of surgery were analyzed.

Results: Lesion of NLR was diagnosed in 5.1%, hypocalcaemia in 16.7%, hypoparathyroidism in 5.8% and postoperative haemorrhage in 1.7%. Hypocalcaemia and transient hypoparathyroidism were more frequently diagnosed in women (P=0.011), patients operated for Graves-Basedow disease (P=0.009) and with lower thyroid volume (P=0.028). Injury of NLR was more frequently detected in retrosternal goiter (P=0.008) and in larger volume of thyroid gland (P=0.045). A higher incidence of bleeding occurred in patients with retrosternal (P=0.015), larger (P=0.012) and Graves-Basedow (P=0.024) goiter.

Conclusion: To prevent the thyroid surgery complications, perfect knowledge of anatomy of thyroid gland and its surrounding structures, fine and precise preparation, thorough haemostasis, identification and dissection of recurrent laryngeal nerve and parathyroid glands are necessary.

Keywords:

thyroidectomy – risk factors – complications

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