Comparison of the Complications of Subtotal, Near Total and Total Thyroidectomy in the Surgical Management of Multinodular Goitre

Özbaş, Serdar; Koçak, Savaş; Aydıntuğ, Semih; Çakmak, Atıl; Demirkıran, Mehmet Ali; Wishart, Gordon

doi:10.1507/endocrj.52.199

Cited by 152 publications

(157 citation statements)

References 27 publications

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“…It is noted that the degree and duration of hypoparathyroidism increase with the extent of thyroid surgery [24]. Ozbas and colleagues reported that the incidence of temporary hypoparathyroidism had increased with the extent of the surgery however, they also reported that extent of the surgery had no effect on permanent hypoparathyroidism [14]. However we found that surgery type is not a statistically significant factor that affects on hypoparathyroidism.…”

Section: Discussioncontrasting

confidence: 48%

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The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

et al. 2010

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Thyroid gland is an important endocrine organ because of its functions. Although the morbidity and mortality of thyroid surgery have decreased markedly, serious complications may still occur. The aim of this retrospective study was to identify the factors influencing the complications in benign nodular thyroid surgery. A total of 332 patients who underwent thyroid surgery between April 2004 and May 2008 were evaluated retrospectively to identify the factors influencing the complications. We found that in surgery lasting more than 90 minutes the risk of permanent recurrent laryngeal nerve (RLN) injury was high, daily drainage more than 50 cc increases the risk of seroma formation, retrosternal goiter surgery have higher risk for bleeding. The flap edema rates were high found in the operations made by resident surgeon and patients with size 3-4 thyroid glands. Low complication rates can be achieved after thyroidectomy with better knowledge of the surgical anatomy of the neck, thyroid pathology and required surgical treatment.

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Section: Discussioncontrasting

confidence: 48%

“…The three main complications following thyroid surgery include RLN palsy, hypoparathyroidism and postoperative hemorrhage [14].…”

Section: Discussionmentioning

confidence: 99%

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

et al. 2010

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“…Several assumptions led to this widely shared behavior. The major reasons included the following: low complication rate associated with TT (as reported by several authors) [27][28][29], risk of relapse after hemithyroidectomy [5,7], risk of an occult malignancy [30] that makes follow-up complex, and/or greater difficulty in performing the revision surgery after thyroid lobectomy. Several recent studies have emphasized various advantages of hemithyroidectomy [31,32] in selected cases of malignancy [33,34].…”

Section: Discussionmentioning

confidence: 99%

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

Scerrino¹,

Raspanti²,

Attard³

et al. 2017

Langenbecks Arch Surg

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Purpose Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors. Methods A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre-and postoperative thyroid hormone levels, and BMI outside the normal range. Demographics; smoking and alcoholism addiction; cardiac, pulmonary, renal, and hepatic failure; diabetes; anxiety; and depression were recorded. The Brief Fatigue Inventory (BFI) was used to evaluate CA and its possible association with these comorbidities 6 and 12 months after thyroidectomy. Results One hundred seventy-seven patients underwent total thyroidectomy (TT), 54 hemithyroidectomy (HT). Thirty-two patients were not recorded because of the onset of exclusion criteria. In the 6 months after thyroidectomy, in the TT group, 64 patients (36.16%) reported an impairment in the BFI score and only 1 in the TL group. The mean BFI score changed from 1.663(±1.191) to 2.16 (±11.148) in the TT group, from 1.584 (±1.371) to 1.171 (±1.093) in the TL group (p < 0.001). No further significant variations in BFI were reported 1 year after surgery. Conclusions CA worsened after TT, but not after HT. Apart from operative procedure itself, no other risk factor was found be significantly associated with post-thyroidectomy asthenia. Further investigation is needed to determine the causes of CA.

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“…In total thyroidectomy group, 30% had transient hypocalcaemia whereas only 0.4% suffered permanent hypoparathyroidism. 17 According to Lee YS et al the most common surgical complication was symptomatic hypoparathyroidism, of which 28.4% of cases were transient and 0.3% permanent. 18 Efremidou EI et al had permanent hypocalcemia in 0.3% and temporary hypocalcemia occurred in 7.3% of patients.…”

Section: Resultsmentioning

confidence: 99%

Hypoparathyroidism, an innate risk of thyroidectomy

2017

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Background: The identification and preservation of parathyroid glands (PT) with its intact blood supply is of utmost importance during thyroid surgery. To preserve the PT with intact blood supply, a medial to lateral dissection is advocated, with plane of dissection along the thyroid capsule. One of the earliest and feared complications of thyroidectomy is hypoparathyroidism (HPT). Aim was to study the incidence of temporary and permanent hypoparathyroidism during thyroidectomy.Methods: This was a hospital based prospective study, from 2008 to 2015. 472 cases who underwent thyroidectomy (182 near total and 290 total thyroidectomies) for any indications in general surgery department of a tertiary care centre were included.Results: The incidence of permanent and transient HPT after total thyroidectomy was 3.8 and 09%, where as it was 2.75 and 3.85% after near total thyroidectomy. The results of present study were comparable with other studies.Conclusions: Meticulous dissection, absolute hemostasis, and a thorough knowledge of neck anatomy are the key in reducing the post thyroidectomy complications. Transient or permanent hypo parathyroidism is due to inadvertent gland removal or injury to its vascular pedicle. Dissection close to the thyroid capsule and ligation of capsular branches of thyroid avoiding the main trunk of inferior thyroid artery holds the key.

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Comparison of the Complications of Subtotal, Near Total and Total Thyroidectomy in the Surgical Management of Multinodular Goitre

Cited by 152 publications

References 27 publications

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

Hypoparathyroidism, an innate risk of thyroidectomy

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