Thyroidectomy in patients with a high BMI: a safe surgery?

Finel, Jean-Baptiste; Mucci, S.; Branger, Frédéric; Venara, Aurélien; Lenaoures, P; Rodien, Patrice; Hamy, A.

doi:10.1530/eje-14-0063

Cited by 32 publications

(33 citation statements)

References 17 publications

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“…Another explanation might be the size of the incision in severely obese patients, that is, the surgeon might have used a larger incision to facilitate the visualization of the RLN and the parathyroid glands in severely obese patients. Unfortunately, the incision length has not been reported in our study or in previously published ones . Finel et al reported that the duration of TT was longer in patients with BMI ≥25 compared to that normal weight patients (103.7 minutes vs 91.55 minutes, P = .007) .…”

Section: Discussioncontrasting

confidence: 65%

“…Unfortunately, the incision length has not been reported in our study or in previously published ones. 11,12 Finel et al reported that the duration of TT was longer in patients with BMI ≥25 compared to that normal weight patients (103.7 minutes vs 91.55 minutes, P = .007). 12 11,12 Surprisingly, postoperative pain severity was not different between groups.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 Finel et al reported that the duration of TT was longer in patients with BMI ≥25 compared to that normal weight patients (103.7 minutes vs 91.55 minutes, P = .007). 12 11,12 Surprisingly, postoperative pain severity was not different between groups. One might suppose that more cervical stretching is required in obese patients than in other patients, resulting in more pain, which could also be increased by a longer and more difficult procedure.…”

Section: Discussionmentioning

confidence: 99%

“…10 Regarding obesity in thyroid surgery, literature data are limited. Prospective studies include a small number of patients (less than 400), 11,12 and the largest series do not evaluate thyroidectomy-specific complications, such as RLN palsies and hypocalcaemia. [13][14][15] The aim of this study was to evaluate the impact of obesity on postthyroidectomy morbidity in a prospective multicenter cohort.…”

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confidence: 99%

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Impact of body mass index on post‐thyroidectomy morbidity

et al. 2019

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Background The impact of obesity on total thyroidectomy (TT) morbidity (recurrent laryngeal nerve palsy and hypocalcaemia) remains largely unknown. Methods In a prospective study (NCT01551914), patients were divided into five groups according to their body mass index (BMI): underweight, normal weight, overweight, obese, and severely obese. Preoperative and postoperative serum calcium was measured. Recurrent laryngeal nerve (RLN) function was evaluated before discharge, and if abnormal, at 6 months. Results In total 1310 patients were included. Baseline characteristics were similar across BMI groups except for age and sex. Postoperative hypocalcaemia was more frequent in underweight compared to obese patients but the difference was not statistically significant in multivariate analysis. There was no difference between groups in terms of definitive hypocalcaemia, transient and definitive RLN palsy, and postoperative pain. Conclusion Obesity does not increase intraoperative and postoperative morbidity of TT, despite a longer duration of the procedure.

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of body mass index on post‐thyroidectomy morbidity

et al. 2019

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“…It is associated with many diseases including heart disease, stroke, diabetes, musculoskeletal disorders, and cancers . There have been several studies investigating the effect of obesity on open thyroidectomy . Three of these studies found that obesity did not significantly affect blood loss, complication rate, or hospital length of stay .…”

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confidence: 99%

Obesity May Not Affect Outcomes of Transoral Robotic Thyroidectomy: Subset Analysis of 304 Patients

et al. 2019

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Objectives/Hypothesis: Obesity is an increasing health concern worldwide. It has been associated with perioperative complications that could affect patient outcomes. Our aim was to compare surgical outcomes in obese and nonobese patients after transoral robotic thyroid (TORT) surgery.Study Design: Retrospective cohort study.Methods: A total of 304 consecutive patients who underwent TORT between January 2012 to December 2017 were included in the study. Patients were divided into two groups according to their body mass index (BMI): BMI < 30 kg/m 2 and BMI ≥ 30 kg/m 2 . Patient demographics, operative extent, pathological data, surgical outcomes, and postoperative complications were included and analyzed. A χ 2 test was used to compare categorical variables, and a Student t test was used to compare changes of continuous variables between groups. Statistical significance was conferred by a two-tailed P value of ≤.05.Results: There were 290 patients in the non-obese group and 14 patients in the obese group. There was no statistically significant difference between the two groups in terms of patient demographics, operative procedure, or pathological characteristics. The only statistically significant difference was for lymph node dissection (P = .012); however, for both groups, unilateral central node dissection was the most common procedure. There was also no statistically significant difference found for operative time, length of stay, pain score, or postoperative complications including TORT-specific complications such as oral commissure tear and general complications such as recurrent nerve injury.Conclusions: This initial experience shows that TORT appears to be a safe and feasible option for obese patients pursuing scarless thyroid surgery.

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Management of Postthyroidectomy Hypoparathyroidism and Its Effect on Hypocalcemia‐Related Complications: A Meta‐Analysis

van Dijk,

van Driel,

van Kinschot

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveThe aim of this Meta‐analysis is to evaluate the impact of different treatment strategies for early postoperative hypoparathyroidism on hypocalcemia‐related complications and long‐term hypoparathyroidism.Data SourcesEmbase.com, MEDLINE, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and the top 100 references of Google Scholar were searched to September 20, 2022.Review MethodsArticles reporting on adult patients who underwent total thyroidectomy which specified a treatment strategy for postthyroidectomy hypoparathyroidism were included. Random effect models were applied to obtain pooled proportions and 95% confidence intervals. Primary outcome was the occurrence of major hypocalcemia‐related complications. Secondary outcome was long‐term hypoparathyroidism.ResultsSixty‐six studies comprising 67 treatment protocols and 51,096 patients were included in this Meta‐analysis. In 8 protocols (3806 patients), routine calcium and/or active vitamin D medication was given to all patients directly after thyroidectomy. In 49 protocols (44,012 patients), calcium and/or active vitamin D medication was only given to patients with biochemically proven postthyroidectomy hypoparathyroidism. In 10 protocols (3278 patients), calcium and/or active vitamin D supplementation was only initiated in case of clinical symptoms of hypocalcemia. No patient had a major complication due to postoperative hypocalcemia. The pooled proportion of long‐term hypoparathyroidism was 2.4% (95% confidence interval, 1.9‐3.0). There was no significant difference in the incidence of long‐term hypoparathyroidism between the 3 supplementation groups.ConclusionsAll treatment strategies for postoperative hypocalcemia prevent major complications of hypocalcemia. The early postoperative treatment protocol for postthyroidectomy hypoparathyroidism does not seem to influence recovery of parathyroid function in the long term.

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Thyroidectomy in patients with a high BMI: a safe surgery?

Cited by 32 publications

References 17 publications

Impact of body mass index on post‐thyroidectomy morbidity

Impact of body mass index on post‐thyroidectomy morbidity

Obesity May Not Affect Outcomes of Transoral Robotic Thyroidectomy: Subset Analysis of 304 Patients

Management of Postthyroidectomy Hypoparathyroidism and Its Effect on Hypocalcemia‐Related Complications: A Meta‐Analysis

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