Endoscopic thyroid and parathyroid surgery in Japan: a cohort study using a Japanese claims database

Minimally invasive techniques are increasingly required in neoplastic surgeries to enhance intraoperative safety and reduce post-operative complications. Endoscopic thyroid and parathyroid surgeries were introduced in the late twentieth century and have been covered by health insurance since 2016 in Japan.

This study aimed to evaluate the frequency and risk factors for post-operative complications following endoscopic thyroid and parathyroid surgeries using a nationwide claims database in Japan.

We conducted a retrospective cohort study by using an insurance claims database. Patients who underwent endoscopic thyroid or parathyroid surgery between April 2016 and December 2022 were included. The incidence of complications such as recurrent laryngeal nerve (RLN) palsy, hypocalcemia, post-operative hemorrhage, infection, and laryngeal edema was investigated. Univariable and multivariable logistic regression analyses were performed to examine risk factors for complications.

Overall, 274 patients were analyzed, with RLN palsy observed in 15 (5.47%), hypocalcemia in 14 (5.11%), and post-operative hemorrhage in 5 (1.82%) patients. Male sex was identified as a significant risk factor for post-operative hemorrhage, whereas total thyroidectomy was associated with hypocalcemia.

Endoscopic thyroid and parathyroid surgeries in Japan have demonstrated favorable safety profiles with low complication rates.