Adverse Events in Thyroid Surgery. Observational Study in Three Surgical Units With High Volume/Year.

Abstract

Background Thyroid surgery, performed for benign or malignant pathologies, is one of the most frequently performed procedures and its frequency has even been increasing in recent years. Postoperative bleeding, recurrent laryngeal nerve (RLN) palsy, associated to dysphonia, dysphagia, dyspnea, and hypoparathyroidism represent the most fearful and common complications. We conducted a multicenter, observational study of retrospectively collected data in three high-volume referral centers, enrolling all patients undergone to thyroid surgery between January 2016 and December 2017 in Parma University Hospital, Cagliari University Hospital and Ferrara University Hospital.Materials Patients were divided into 5 groups, differentiated thyroid carcinoma, medullary thyroid carcinoma, non-toxic benign pathology, hyperfunctioning benign pathology and NIFTP (Non-invasive Follicular Thyroid neoplasm with Papillary-like nuclear features). A follow up at 7 and 30 days was executed, evaluating the onset of paresthesia, dysphonia and dysphagia. A six-month follow-up was conducted in cases of early complications.Results Totally, 1252 patients were eligible for the study: 907 female and 345 male, with a female to male ratio of 2.6:1 and an average age of 53.428. Total thyroidectomy was performed in 1022 cases, lobectomy in 230.After 6 months we recorded paresthesia in 0.5%, dysphonia in 1.8% and dysphagia in 0.5%.Conclusion Our study confirms once again that a share of morbidity escapes the possibilities of prediction and control by the operator, depending on patient anamnestic, pathological or anatomical factors.

The impact of intraoperative “Nerve Monitoring” in a tertiary referral center for thyroid and parathyroid surgery

“…Thyroidectomy is one of the most frequent surgical procedures in general surgery Units (1) with about 40.000 thyroidectomies performed in Italy every year (66.66/ 100.000 inhabitants) (2). Unilateral or bilateral temporary or definitive recurrent laryngeal nerve (RLN) injuries are among the most frightening complications during thyroidectomy, leading to voice and swallowing alterations (3).…”