Complications of Thyroid Surgery: How to Avoid Them, How to Manage Them, and Observations on Their Possible Effect on the Whole Patient

Reeve, T. S.; Thompson, Norman W.

doi:10.1007/s002680010160

Cited by 361 publications

(262 citation statements)

References 17 publications

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“…There is a wide variation in the reported incidence ranging from 1.6% to 50%. However, most surgical units experienced persistent dysfunction in TT a rate of 2% or less [10].…”

Section: Discussionmentioning

confidence: 99%

“…There is a risk of iatrogenic injury to the parathyroid glands during any operation in which both lobes of the thyroid gland are explored or removed, although permanent hypoparathyroidism may not be duo to direct injury alone [10]. Hypocalcemia following thyroidectomy is usually temporary.…”

Section: Discussionmentioning

confidence: 99%

“…The main concern is the potentially high rate of complications such as hematoma, permanent recurrent laryngeal nerve (RLN) paralysis and hypoparathyroidism [8,9]. A large or intrathoracic goiter, extensive malignancy, secondary procedure, inexperience of the surgical team and extent of the operation are the criteria that increase the complication rate [10][11][12]. The aim of this retrospective study is to identify factors influencing complications in benign nodular thyroid surgery.…”

Section: Introductionmentioning

confidence: 99%

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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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“…There is a wide variation in the reported incidence ranging from 1.6% to 50%. However, most surgical units experienced persistent dysfunction in TT a rate of 2% or less [10].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

et al. 2010

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“…[1][2][3] While a variety of factors (eg postoperative hypertension, use of anticoagulants and extent of dissection) have been implicated in increasing the risk of post-thyroidectomy haemorrhage, it is generally considered a low frequency stochastic event, which is difficult to predict. [4][5][6][7] Bleeding deep to the strap muscles is associated with a higher risk of life threatening airway swelling and obstruction, and the risk of post-thyroidectomy haemorrhage is highest in the early hours following surgery. 8 For these reasons, patients traditionally remained in hospital for 72 hours or longer after thyroidectomy.…”

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confidence: 99%

Patterns, timing and consequences of post-thyroidectomy haemorrhage

Farooq

Nouraei

Kaddour

et al. 2017

annals

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INTRODUCTION Post-thyroidectomy bleeding is a low frequency but potentially life threatening event that is very difficult to predict. Given the increasing drive towards thyroidectomy with same day discharge, this study was conducted with the aim of identifying patterns, timing and consequences of post-thyroidectomy bleeding to assess the feasibility of day-case thyroidectomy. METHODS All patients who underwent a thyroidectomy between 2008 and 2015 at our institution were identified. Patterns, timing and consequences in all those who developed post-thyroidectomy bleeding were studied. RESULTS Of the 805 patients included in the study, 14 required re-exploration for bleeding; 7 (50%) of these within 8 hours of surgery, 6 (43%) between 18 and 30 hours, and 1 (7%) at 49 hours. Just under half (43%) of those with post-thyroidectomy bleeding had thyrotoxicosis. CONCLUSIONS A significant number of postoperative haemorrhages occurred beyond the immediate postoperative period. Same day discharge after thyroidectomy cannot therefore be recommended as a routine practice.

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“…But a calcium decrease can take sometimes 48 or more hours. Some authors propose risk factors (gender, thyrotoxicosis, cancer, retrosternal goitre) of postoperative hypocalcemia (1,2,3). It is impossible to predict the risk for each individual patient and make decisions reagarding duration of hospital stay or treatment strategy upon this risk factors.…”

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confidence: 99%

Hypocalcemia – the most common complication after total thyroidectomy

Cmilansky¹,

L²

2014

BLL

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Abstract:Objectiva: Postoperative intact parathyroid hormone (iPTH) levels and some other factors as a predictor of hypocalcemia are analyzed in 115 patients after TTE. Background: Postoperative hypocalcemia is the most common complication observed after total thyroidectomy (TTE). It is not easy to predict in which patients this complication will occur. We adopted and implemented a novel method to predict this complication -monitoring of postoperative intact parathyroid hormone (iPTH) levels. Methods and results: Prospective study involves 115 patients. From January till December 2010 we performed 111 TTE and 4 completion thyreoidectomies (hemithyreoidectomy (HTE) after previous HTE). Gender and age of patients, fi nal histopatology diagnosis, number of parathyroid glands visible during operation, duration of operation and surgeon were factors that did not infl uence development of postoperative hypocalcemia. A hospital stay was prolonged in patients with hypocalcemia. iPTH level morning after surgery less than 15 pg/ml was a statistically signifi cant predictor of postoperative hypocalcemia. Sensitivity, specifi city, positive and negative predictive value of iPTH<15 pg/ml for predicting postoperative hypocalcemia were 71 %, 99 %, 97 % and 86 %, respectively. Sensitivity of iPTH<15 pg/ml in predicting symptomatic postoperative hypocalcemia was 100 %. Conclusion: Measuring iPTH levels morning after TTE allows prediction of subsequent hypocalcemia with a high sensitivity, specifi city, PPV and NPV. Normal iPTH levels ruled out development of hypocalcemia symptoms. Patients with normal iPTH can be safely discharged and the overtreatment of postthyroidectomy patients with calcium and/or vitamin D supplements can be also avoided (Tab. 2, Fig. 3 Acknowledgement: I would like to thank prof. MUDr. Astl J., CSc., Department of ENT, head and neck surgery, Na Homolce Hospital, Prague, Czech Republic who helped me to start with thyroid surgery. My thanks also belongs to prof. MUDr. Starek I.,CSc., ENT clinic, Faculty Hospital Olomouc, Czech Republic and Doc. MUDr. Fryšák Z., CSc., 3rd intern clinic, Faculty Hospital Olomouc, Czech Republic for critical revision and for support to organise this study.

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Complications of Thyroid Surgery: How to Avoid Them, How to Manage Them, and Observations on Their Possible Effect on the Whole Patient

Cited by 361 publications

References 17 publications

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

Patterns, timing and consequences of post-thyroidectomy haemorrhage

Hypocalcemia – the most common complication after total thyroidectomy

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