The BMI impact on thyroidectomy-related morbidity; a case-matched single institutional analysis

Area of Science:

• Endocrinology
• Surgical Oncology
• Bariatric Surgery

Background:

• Obesity is a growing concern linked to increased postoperative complications.
• Thyroidectomy is a common surgical procedure for various thyroid conditions.
• Understanding the impact of obesity on thyroidectomy outcomes is crucial for patient care.

Purpose of the Study:

• To investigate the association between Body Mass Index (BMI) and surgical complications after total thyroidectomy.
• To compare the rates of hypoparathyroidism and recurrent laryngeal nerve palsy in obese versus non-obese patients undergoing thyroidectomy.

Main Methods:

• Retrospective analysis of 484 patients undergoing open total thyroidectomy at a single academic center.
• Patients were categorized into non-obese (BMI < 30 kg/m²) and obese (BMI ≥ 30 kg/m²) groups.
• 1:2 case matching based on age, gender, and disease type (benign/malignant) created homogenous groups for comparison.

Main Results:

• After matching, 193 non-obese and 98 obese patients were analyzed.
• No significant differences were observed in transient or permanent hypoparathyroidism and recurrent laryngeal nerve palsy rates between groups.
• Obesity (BMI ≥ 30 kg/m²) was associated with significantly longer operative times (p=0.018).

Conclusions:

• Total thyroidectomy can be safely performed in obese patients without an increased risk of major surgical morbidity.
• While operative times may be longer in obese individuals, key complication rates remain comparable.
• BMI should not be a contraindication for thyroidectomy, emphasizing patient safety regardless of weight.