Postoperative Complications After Thyroidectomy: Time Course and Incidence Before Discharge

Fassas, Scott; Mamidi, Ishwarya S.; Lee, Ryan; Pasick, Luke J.; Benito, Daniel A.; Thakkar, Punam; Joshi, Arjun S.; Goodman, Joseph

doi:10.1016/j.jss.2020.11.008

Cited by 15 publications

(17 citation statements)

References 22 publications

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“…9,10,13 Our study also demonstrated a higher rate of complications in total thyroidectomy compared to thyroid lobectomy, which is consistent with most literature. 18,21 However, there are a few studies on post-operative complications assessing the two procedures that have found no difference based on the extent of surgical resection. 12,22,23 This may reflect variations in methodology and, in this regard, it is important to note that our study is based on non-thyroid specific outcomes.…”

Section: Discussionmentioning

confidence: 99%

Risk Assessment in Thyroid Lobectomy and Total Thyroidectomy using Over 100 Thousand Cases

Brauer

Burkey

Reddy

et al. 2021

Ann Otol Rhinol Laryngol

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Objectives: To assess risk factors and non-thyroid specific postoperative complications for thyroid lobectomy compared to total thyroidectomy. Methods: A retrospective, cross-sectional study of adults undergoing a lobectomy or total thyroidectomy using the National Surgical Quality Improvement Program database between 2005 and 2017. Patients not treated by otolaryngologists or general surgeons and with unknown demographic variables were excluded. Results: A total of 106 915 patients were analyzed, 64 763 total thyroidectomies and 42 152 lobectomies. Multivariable analysis demonstrated that total thyroidectomy patients were half as likely to return to the operating room (OR = 0.491 (95%CI 0.445-0.542), P < .001). Within this cohort, patients at greater risk for reoperation had a history of hypertension (OR = 1.225 (95%CI 1.090-1.376), P < .001), a malignant pathology (OR = 1.921 (95%CI 1.734-2.128), P < .001), and smoked (OR = 1.237 (95%CI 1.087-1.407), P = .001). Conversely, diabetes and body mass index did not impact the rate of reoperation when assessing total thyroidectomy and lobectomy. The most frequent non-thyroid specific complications in total thyroidectomy were unplanned intubation (0.5%), urinary tract infection (0.3%), and superficial surgical site infection (0.3%). In thyroid lobectomy, the most common complications were superficial surgical site infection (0.3%) and urinary tract infection (0.2%). Conclusions: Our multi-institutional study indicates specific risk factors for returning to the operating room that may warrant closer follow up after surgery for total thyroidectomy or thyroid lobectomy. We also identified the most common post-operative complications. During pre-operative planning, these findings should be considered by thyroid surgeons to help mitigate risk to patients.

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Section: Discussionmentioning

confidence: 99%

Risk Assessment in Thyroid Lobectomy and Total Thyroidectomy using Over 100 Thousand Cases

Brauer

Burkey

Reddy

et al. 2021

Ann Otol Rhinol Laryngol

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“…13 Only around 0.11% of patients undergoing thyroidectomy require BT. 14 Due to this rarity, there is paucity of data on BT in thyroidectomy patients, and therefore, risk factors and outcomes of BT in this population remain unknown. [15][16][17] Previously published data are based on single center experiences with small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

“…Evidence from studies conducted on animals undergoing thyroidectomy indicates poor survival rates among BT recipients 13 . Only around 0.11% of patients undergoing thyroidectomy require BT 14 . Due to this rarity, there is paucity of data on BT in thyroidectomy patients, and therefore, risk factors and outcomes of BT in this population remain unknown 15–17 .…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

et al. 2022

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Objectives To assess the incidence, risk factors, and complications of blood transfusions (BTs) in elective thyroidectomy patients. Methods A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program. Adult patients who underwent elective thyroidectomy from 2005 to 2019 were divided into two cohorts based on whether they received BT or not. Multivariable binary logistic regression models were used to identify risk factors of BT and its impact on postoperative complications. Results Of 180,483 patients, 0.13% received BT. Risk factors for BT included underweight body mass index (BMI) (adjusted odds ratio [OR] 3.179, 95% confidence interval [CI] 1.444–6.996), bleeding disorders (OR 2.121, 95% CI 1.149–3.913), anemia (OR 4.730, 95% CI 3.472–6.445), preoperative transfusion (OR 7.230, 95% CI 1.454–35.946), American Society of Anesthesiology physical statuses 3–5 (OR 3.103, 95% CI 2.143–4.492), operative time >150 min (OR 4.390, 95% CI 1.996–9.654), and inpatient thyroidectomy (OR 5.791, 95% CI 3.816–8.787). In addition, transfusion was independently associated with any postoperative complication, non‐infectious, cardiac, pulmonary, renal, vascular, or infectious complications, surgical site infection, sepsis, septic shock, wound disruption, pneumonia, unplanned reoperation, prolonged length of stay, and mortality. Conclusion Recognition of risk factors of BT is imperative to identify at‐risk patients and reduce transfusions by controlling modifiable risk factors such as anemia, operative time, and BMI. In cases where transfusions are still indicated, surgeons should optimize care to prevent or adequately manage transfusion‐associated complications. Level of Evidence 3 Laryngoscope, 132:2078–2084, 2022

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“…At the initial session, the patient should get information outlining potential severe and/or everyday dangers and how to handle them (10) .…”

Section: Complications Of Thyroidectomymentioning

confidence: 99%

“… Potentially fatal side effects include cardiac arrhythmias.  Modifications to cardiac output (10) .…”

Section: Clinical Picturementioning

confidence: 99%

Relevant Correlation between Hypocalcemia and Thyroidectomy Operation: Review Article

Attia¹,

Alshrif²,

Omar³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: One of the most popular surgical procedures performed worldwide is thyroid surgery, which is regarded as the best solution for benign conditions like multinodular goitre with compressive symptoms and thyroid cancer. The most common side effects of thyroid surgery include postoperative haemorrhage, parathyroid insufficiency, and recurrent laryngeal nerve damage. The removal of the glands during surgery may cause hypoparathyroidism. Following thyroidectomy, hypocalcemia is a common consequence that has a high risk of mortality and has been linked to longer hospital stays, postoperative problems, and higher readmission rates. Objective: Assessment of incidence of hypocalcemia as postoperative complication of thyroidectomy operation. Methods: We searched PubMed, Google Scholar, and Science Direct for information on hypocalcemia with thyroidectomy. However, only the most current or comprehensive study from February 2004 to July 2022 was considered. The authors also assessed references from pertinent literature. Documents in languages other than English have been disregarded since there aren't enough resources for translation. Unpublished manuscripts, oral presentations, conference abstracts, and dissertations were examples of papers that weren't considered to be serious scientific research. Conclusion: A highly effective and simple predictor of hypocalcemia in individuals undergoing total thyroidectomy is the comparison of the post-operative drop in calcium levels to the immediate pre-operative readings.

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Postoperative Complications After Thyroidectomy: Time Course and Incidence Before Discharge

Cited by 15 publications

References 22 publications

Risk Assessment in Thyroid Lobectomy and Total Thyroidectomy using Over 100 Thousand Cases

Risk Assessment in Thyroid Lobectomy and Total Thyroidectomy using Over 100 Thousand Cases

A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

Relevant Correlation between Hypocalcemia and Thyroidectomy Operation: Review Article

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