The morbidity of total thyroidectomy

Area of Science:

• Endocrinology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Thyroidectomy is a common surgical procedure.
• Previous irradiation of the head and neck is a known risk factor for thyroid pathology.
• The long-term outcomes of total thyroidectomy in patients with prior irradiation require evaluation.

Purpose of the Study:

• To assess the outcomes of total thyroidectomy in patients with a history of head and neck irradiation.
• To evaluate the short-term and long-term morbidity associated with this procedure.

Main Methods:

• Retrospective review of 245 total thyroidectomies performed over a ten-year period.
• Analysis of patient history, focusing on prior head and neck irradiation for benign conditions.
• Assessment of operative mortality, postoperative bleeding, recurrent laryngeal nerve function, and calcium requirements.

Main Results:

• No operative mortality was observed.
• One patient (0.4%) required reoperation for postoperative bleeding.
• Recurrent laryngeal nerve function recovered in 5 out of 6 patients within one year.
• Postoperative hypocalcemia requiring calcium supplementation decreased significantly from hospital discharge to one year post-surgery.

Conclusions:

• Total thyroidectomy can be performed with low morbidity and mortality in patients with prior head and neck irradiation.
• Long-term complications, such as hypocalcemia, are infrequent.
• The benefits of total thyroidectomy should be weighed against potential long-term morbidity, not just immediate postoperative risks.