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Local complications after surgical resection for thyroid carcinoma
M B Flynn1, K J Lyons, J W Tarter
1Department of Surgery, University of Louisville, School of Medicine, Kentucky 40292.
Background:
One of the issues in the debate surrounding the extent of thyroid excision for localized, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection. This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer.
Materials And Methods:
Ninety-one patients with thyroid carcinoma were identified from tumor registries at a university, veterans administration, and private hospital over a 36-year period. Forty-five patients (49%) underwent total thyroidectomy, 28 (31%) subtotal thyroidectomy, and 18 (20%) thyroid lobectomy.
Results:
Permanent postoperative local complications occurred in 4% of patients. Forty-four patients (48%) experienced temporary local complications: transient hypocalcemia in 38 (42%), airway obstruction in 3 (3%), postoperative bleeding in 2 (2%), and recurrent laryngeal nerve injury in 1 (1%). The local complication rate increased in direct relationship to the extent of thyroid resection. There were no postoperative deaths.
Conclusion:
The most frequent underreported morbidity after thyroid resection is transient hypocalcemia. Compared to other life-threatening or permanent postoperative complications that could occur, transient hypocalcemia is relatively less important, and the significance of its identification is predominantly economic.