Advertisement

Annals of Surgical Oncology

, Volume 2, Issue 1, pp 56–60 | Cite as

Complications of thyroid surgery

  • Diderick B. W. de Roy van Zuidewijn
  • Ilfet Songun
  • Job Kievit
  • Cornelis J. H. van de Velde
Original Articles

Abstract

Background: The morbidity of thyroid surgery is low. Despite this, some authors advocate a subtotal thyroidectomy instead of a total thyroidectomy, to avoid the higher morbidity associated with a total thyroidectomy.

Methods: We retrospectively evaluated the complications of thyroid surgery in Leiden between January 1, 1982 and October 1, 1990. Three hundred forty-one patients—261 women and 80 men—had 356 operations; 15 patients were operated on twice; there were 152 total hemithyroidectomies, 3 subtotal hemithyroidectomies, 33 total thyroidectomies, 122 bilateral subtotal hemithyroidectomies, 12 combinations of total and subtotal hemithyroidectomies, and 34 other operations.

Results: Calculated for the nerves at risk (n=489), the percentage of permanent recurrent nerve lesions was 3.1 (in the 5 most recent years it was 1.2%). There was no significant difference between total or subtotal (hemi)thyroidectomies. Initial symptomatic hypocalcemia necessitating supplementation was encountered 42 times (12.5%). The occurrence of permanent symptomatic hypocalcemia (6%) was not significantly different between total and subtotal (hemi)thyroidectomies (p=0.06). The duration of surgery was 137.8 min for bilateral subtotal thyroidectomies and 182.9 min for bilateral total thyroidectomies (p<0.0001). There was no difference in blood loss between total and subtotal (hemi)thyroidectomies.

Conclusions: Because total thyroidectomy carries a risk of complications similar to that for subtotal thyroidectomy, it is not logical to avoid total resections. If the number of total resections were increased, it is anticipated that fewer reoperations, which involve a relatively high morbidity rate, would have to be performed.

Key Words

Thyroid surgery Morbidity Complications 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Schroder DM, Chambors A, France CJ. Operative strategy for thyroid cancer: is total thyroidectomy worth the price?Cancer 1986;58:2320–8.PubMedGoogle Scholar
  2. 2.
    Schwartz AE, Friedman EW. Preservation of the thyroid glands in total thyroidectomy.Surg Gynecol Obstet 1987;165:327–32.PubMedGoogle Scholar
  3. 3.
    Harness JK, Fung L, Thompson NW, Burney RE, McLeod MK. Total thyroidectomy: complications and technique.World J Surg 1986;10:781–6.PubMedGoogle Scholar
  4. 4.
    Horch R, Dahl HD, Jaeger K, Schäfer T. Zur Häufigkeit der Rekurrenzparese nach Schilddrüsenoperationen.Zentralbl Chir 1989;114:577–82.PubMedGoogle Scholar
  5. 5.
    Friedman M, Pacella BM Jr. Total versus subtotal thyroidectomy: arguments, approaches, and recommendations.Otolaryngol Clin North Am 1990;23:413–27.PubMedGoogle Scholar
  6. 6.
    Clark OH. Total thyroidectomy: the treatment of choice for patients with differentiated thyroid cancer.Ann Surg 1982;196:361–70.PubMedGoogle Scholar
  7. 7.
    Levin KE, Clark AH, Duh QY, Demeurse M, Siperstein AE, Clark OH. Reoperative thyroid surgery.Surgery 1992;111:604–9.PubMedGoogle Scholar
  8. 8.
    Weitensfelder W, Lexer G, Aigner H, Fellinger H, Trattnig J, Grünbacher G. Die passagere und permanente Rekurrenzparese nach Schildrüsenoperationen. Beeinflussende Faktoren: der Ausbildungsstand des Cirurgen.Zentralbl Chir 1989;114:583–9.PubMedGoogle Scholar
  9. 9.
    Märtensson H, Terins J. Recurrent laryngeal nerve palsy in thyroid gland surgery related to operations and nerves at risk.Arch Surg 1985;120:475–7.PubMedGoogle Scholar
  10. 10.
    Bay V, Engel U. Komplikationen bei Schilddrusenoperationen.Chirurg 1980;51:91–8.PubMedGoogle Scholar
  11. 11.
    Weitensfelder W, Lexer G, Aigner H, Fellinger H, Trattnig J, Grünbacher G. Die langfristige laryngoskopische Nachkontrolle bei Einschrankung der Stimmbandmotilitat nach Strumaoperation.Chirurg 1989;60:29–32.PubMedGoogle Scholar
  12. 12.
    Rieger R, Pimpl W, Riedl E, Boeckl O, Waclawiczek HW. Der Einfluss einer modifizierten Strumaresektionstechnik auf die Rate von Lasionen des Nervus Laryngeus Rekurrens.Chirurg 1985;58:255–60.Google Scholar
  13. 13.
    Reeve TS, Delbridge L, Cohen A, Crummer P. Total thyroidectomy: the preferred option for multinodular goiter.Ann Surg 1987;206:782–6.PubMedGoogle Scholar
  14. 14.
    Cernea CR, Ferraz AR, Furlani J, et al. Identification of the external branch of the superior laryngeal nerve during thyroidectomy.Am J Surg 1992;164:634–9.PubMedGoogle Scholar
  15. 15.
    Cusick EL, Krukowski ZH, Matheson NA. Outcome of surgery for Graves' disease re-examined.Br J Surg 1987;74:780–3.PubMedGoogle Scholar
  16. 16.
    Vara-Thorbeck R, Tovar JL, Rosell J, et al. Die Komplikationen bei blander Strumenoperation: Retrospektive Studie anhand von 2035 eigenen Fallen.Zentralbl Chir 1989;114:571–6.PubMedGoogle Scholar

Copyright information

© The Society of Surgical Oncology, Inc. 1995

Authors and Affiliations

  • Diderick B. W. de Roy van Zuidewijn
    • 1
  • Ilfet Songun
    • 1
  • Job Kievit
    • 1
  • Cornelis J. H. van de Velde
    • 1
  1. 1.Department of SurgeryUniversity HospitalLeidenthe Netherlands

Personalised recommendations