Complications and sequelae of thyroidectomy and an analysis of surgeon experience and outcome

Theodor Kocher is credited with refining the technique of thyroidectomy and reducing the incidence of postoperative hemorrhage. He also recognized the importance of preservation of the parathyroid glands. His accomplishments led to a reduction in surgical mortality, from 50% to less than 4.5%. Additional improvements in technique have reduced the mortality rate to near zero. Morbidity, however, remains a concern for surgeons who perform thyroid surgery. Complications and sequelae of thyroid surgery are reviewed, including recurrent and superior laryngeal nerve injury, temporary hypocalcemia, permanent hypoparathyroidism, thyroid storm, bleeding, wound infection, and hypothyroidism. The association between the volume of thyroidectomies performed by a surgeon and outcome is also discussed in this chapter.