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Large goiters and postoperative complications: does it really matter?

Joaquín Gómez-Ramírez1, Paula Cubillo Heras2, Raquel Arranz Jiménez3

  • 1Endocrine and Breast Surgery Unit, Department of General and Digestive Surgery, Instituto de Investigación, Hospital Universitario La Paz (IdiPAZ), Madrid, Spain. jgomezramirez@hotmail.com.

Langenbeck'S Archives of Surgery
|May 29, 2023
PubMed
Summary

Thyroid gland size is not a significant risk factor for postoperative complications after thyroidectomy. This study found no increased risk of hypoparathyroidism or recurrent laryngeal nerve injury with larger thyroid glands.

Keywords:
ComplicationsGoiterHypoparathyroidismRecurrent injuryThyroidectomy

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Area of Science:

  • Endocrine Surgery
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Thyroidectomy is a common surgical procedure with a low mortality rate.
  • Postoperative complications such as hypoparathyroidism and recurrent laryngeal nerve injury can occur.
  • Traditionally, thyroid gland size has been considered a risk factor, but its independent role is unclear.

Purpose of the Study:

  • To investigate whether thyroid gland size is an independent risk factor for postoperative complications following total thyroidectomy.

Main Methods:

  • Prospective study of 121 patients undergoing total thyroidectomy.
  • Preoperative ultrasound calculated thyroid volume.
  • Correlation of thyroid volume and specimen weight with postoperative complication incidence.

Main Results:

  • No significant differences in transient or permanent hypoparathyroidism incidence across thyroid size quartiles.
  • No increased risk of recurrent laryngeal nerve paralysis observed with larger glands.
  • No correlation found between thyroid size and parathyroid gland visualization or accidental removal.

Conclusions:

  • Thyroid gland size is not an independent risk factor for postoperative complications after thyroidectomy.
  • Findings challenge the traditional assumption linking larger thyroid size to increased surgical risk.