Thyroidectomy in a community hospital: findings of 100 consecutive cases

The objective of this study was to determine the characteristics and surgical outcomes of 100 consecutive cases of thyroidectomy (in 98 patients) at a community hospital from October 2005 to mid-November 2006. Preoperative laryngoscopy was performed in 94% of patients and postoperative laryngoscopy in 100%. Patients' thyroid nodules had been found incidentally in 28% of cases. The two most common indications for surgery were results of fine-needle aspiration biopsy (FNA) in 55% and size of the thyroid in 22% of cases. Of the 98 patients, 79 (81%) had benign diagnoses, 7 (7%) had microcarcinomas, and 12 (12%) had well-differentiated thyroid cancer. Overall, 5 patients (5%) had temporary recurrent laryngeal nerve paralysis, but this occurred in only 1 (1%) patient in the group with smaller lesions, a statistically significant difference (p< 0.02); none had permanent paralysis. Of 36 patients at risk for hypocalcemia, 3 (8%) and 1 (3%) had temporary and long-term hypocalcemia, respectively. There was no incidence of significant hemorrhage. FNA results were very accurate. We show that thyroidectomy can be performed with minimal laryngeal nerve paralysis or other complications. Larger lesions had significantly higher rates of temporary laryngeal nerve paralysis.