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Complications of thyroid surgery
D B de Roy van Zuidewijn1, I Songun, J Kievit
1Department of Surgery, University Hospital, Leiden, The Netherlands.
Annals of Surgical Oncology
|January 1, 1995
Summary
Total thyroidectomy has similar complication risks to subtotal thyroidectomy, making avoidance illogical. Increasing total thyroidectomies may reduce reoperation rates and associated morbidity.
Area of Science:
- Endocrinology
- Surgical Oncology
- General Surgery
Background:
- Thyroid surgery generally has low morbidity.
- Some surgeons prefer subtotal thyroidectomy over total thyroidectomy to minimize potential complications.
Purpose of the Study:
- To compare the complication rates of total thyroidectomy versus subtotal thyroidectomy.
- To evaluate the necessity of avoiding total thyroidectomies based on complication data.
Main Methods:
- Retrospective analysis of 356 thyroid surgeries performed between 1982 and 1990.
- Inclusion of various thyroidectomy types: total hemithyroidectomy, subtotal hemithyroidectomy, total thyroidectomy, and bilateral subtotal hemithyroidectomy.
Main Results:
- Permanent recurrent nerve lesion rates were comparable between total and subtotal thyroidectomies (3.1%).
- Rates of initial (12.5%) and permanent (6%) symptomatic hypocalcemia were not significantly different between the two surgical approaches.
- Bilateral total thyroidectomies had a longer duration (182.9 min) compared to bilateral subtotal thyroidectomies (137.8 min) but similar blood loss.
Conclusions:
- Total thyroidectomy does not present a higher risk of complications compared to subtotal thyroidectomy.
- Avoiding total thyroidectomies is not supported by complication data.
- Increasing the rate of total thyroidectomies could potentially decrease the need for reoperations, which carry higher morbidity.