Advertisement

World Journal of Surgery

, Volume 28, Issue 3, pp 271–276 | Cite as

Complications of Thyroid Surgery: Analysis of a Multicentric Study on 14,934 Patients Operated on in Italy over 5 Years

  • Lodovico RosatoEmail author
  • Nicola Avenia
  • Paolo Bernante
  • Maurizio De Palma
  • Giuseppe Gulino
  • Pier Giorgio Nasi
  • Maria Rosa Pelizzo
  • Luciano Pezzullo
Original Scientific Reports
First Online:

Abstract

Complication rates associated with thyroid surgery can be evaluated only through analysis of case studies and follow-up data. This study covers postoperative data from 14,934 patients subjected to a follow-up of 5 years. Among them, 3130 (20.9%) underwent total lobectomy (TL), 9599 (64.3%) total thyroidectomy (TT), 1448 (9.7%) subtotal thyroidectomy with a monolateral remnant (MRST), and 757 (5.1%) subtotal thyroidectomy with bilateral remnants (BRST). A total of 6% of the patients had already been operated on. Persistent hypoparathyroidism occurred after 1.7% of all the operations, and temporary hypoparathyroidism was noted in 8.3%. Permanent palsy of the laryngeal recurrent nerve (LRN) occurred in 1.0% of patients, transient palsy in 2.0%, and diplegia in 0.4%. The superior laryngeal nerve was damaged in 3.7%; dysphagia occurred in 1.4% of cases, hemorrhage in 1.2%, and wound infection in 0.3%. No deaths were reported. A significant rate of LRN damage was noted, which has an important impact on the patient’s social life. Hypoparathyroidism after total thyroidectomy is an important complication that can be successfully treated by therapy, although it is not always easily managed in special circumstances such as in young persons or pregnant women. The complications associated with thyroid surgery must be kept in mind so the surgeon can carefully evaluate the surgical and medical therapeutic options, have more precise surgical indications, and be able to give the patient adequate information.

Keywords

Goiter Laryngeal Recurrent Nerve Total Thyroidectomy Subtotal Thyroidectomy Laryngeal Superior Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Notes

Acknowledgments.

We thank the multicentric study members of the CLUB delle U.E.C. (Association of the Endocrine Surgical Italian Units): A. Ambrosi (Endocrine Surgical Unit, University of Foggia); A. Arlandini (Galliera Hospital Genova); N. Avenia (Endocrine Surgical Unit, University of Perugia); A. Bastagli (Endocrine Surgical Unit, University of Milano); A. Battilana (S. Giuseppe Hospital Milano); R. Bellantone (Endocrine Surgical Unit, University Catholic of Roma); G. Biliotti (Endocrine Surgical Unit, University of Firenze); D. Borrelli and I. Paulin (Careggi Hospital Firenze); F.P. Campana (Endocrine Surgical Unit, University of Roma); A.M. Cannizzaro (Endocrine Surgical Unit, University of Catania); F. Caruso (Cancer Institute Catania); A. Ciccolo (Endocrine Surgical Unit, University of Messina); M. D’Ajello (Hospital of Foligno); N. D’Alessandro (S. carlo Hospital Potenza); S. De Fina (Endocrine Surgical Unit, University of Monza); U. De Nobili (Endocrine Surgical Unit, University of Brescia); M. De Palma (Cardarelli Hospital Napoli); A. Di Roma (Hospital of Carmagnola); S. Faragona (Umberto I Hospital Ancona); G. Fattovich and G. Trentini (Hospital of Verona); G. Gasparri (Endocrine Surgical Unit, University of Torino); R. Lampugnani (Hospital of Fiorenzuola D’Arda); E. Longo (Tappeiner Hospital Merano); D. Marrano and M. Taffurelli (Endocrine Surgical Unit, University of Bologna); E. Melchiorri (Hospital of Tolentino); G. Melotti, M. Piccoli, and M.G. Lazzaretti (S. Agostino Hospital Modena); F. Mento (Barone Romeo Hospital Patti); A. Mussa and M. Deandrea (Endocrine Surgical Unit, University of Torino); P.G. Nasi (Mauriziano Hospital Torino); U. Parmeggiani (Endocrine Surgical Unit, University of Napoli); E. Passeri (Hospital of Gubbio); M.R. Pelizzo (Endocrine Surgical Unit, University of Padova); P. Petrillo (Rummo Hospital Benevento); L. Pezzullo (Cancer Institute Napoli); C. Pietrantuono (Cardarelli Hospital Campobasso); R. Pugliese and M. Boniardi (Niguarda Ca’ Granda Hospital Milano); A. Robecchi and N. Palestini (Endocrine Surgical Unit, University of Torino); M. Romano (Endocrine Surgical Unit, University of Palermo); L. Rosato (Hospital of Ivrea); M. Sianese (Endocrine Surgical Unit, University of Parma); S. Spiezia (Incurabili Hospital Napoli); G. Trombatore (Hospital of Lentini).

References

  1. 1.
    Reeve, T, Thompson, NW 2000Complications of thyroid surgery: how to avoid them, how to manage them, and observations on their possible effect on the whole patientWorld J. Surg.24971975CrossRefPubMedGoogle Scholar
  2. 2.
    Rosato, L, Mondini, G, Ginardi, A,  et al. 2000Incidence of complications of thyroid surgeryMinerva Chir.55693702PubMedGoogle Scholar
  3. 3.
    Bliss, RD, Gauger, PG, Delbridge, LW 2000Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of techniqueWorld J. Surg.24891897CrossRefPubMedGoogle Scholar
  4. 4.
    Sasson, AR, Pingpank, JF, Wetherington, RW,  et al. 2001Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcaemiaArch. Otolaryngol. Head Neck Surg.127304308PubMedGoogle Scholar
  5. 5.
    Pattou, F, Combemale, F, Fabre, S,  et al. 1998Hypocalcemia following thyroid surgery: incidence and prediction of outcomeWorld J. Surg.22718724CrossRefPubMedGoogle Scholar
  6. 6.
    Dolapci, M, Doganay, M, Reis, E,  et al. 2000Truncal ligation of the inferior thyroid arteries does not affect the incidence of hypocalcaemia after thyroidectomyEur. J. Surg.166286288CrossRefPubMedGoogle Scholar
  7. 7.
    Araujo Filho, VJ, Silva Filho, GB, Brandao, LG,  et al. 2000The importance of the ligation of the inferior thyroid artery in parathyroid function after subtotal thyroidectomyRev. Hosp. Clin. Fac. Med. Sao Paulo55113120PubMedGoogle Scholar
  8. 8.
    Olson, JA, Benedetti, MK, Baumann, DS,  et al. 1996Parathyroid autotransplantation during thyroidectomy: results of long-term follow-upAnn. Surg.223472474CrossRefPubMedGoogle Scholar
  9. 9.
    Henry, JF, Denizot, A, Audiffret, J 1990Autotransplantation parathyroidienne de nécessité en chirurgie thyroidienneAnn. Chir.44378381PubMedGoogle Scholar
  10. 10.
    D’Avanzo, A, Parangi, S, Morita, E,  et al. 2000Hyperparathyroidism after thyroid surgery and autotransplantation of histologically normal parathyroid glandsJ. Am. Coll. Surg.190546552CrossRefPubMedGoogle Scholar
  11. 11.
    Balanzoni, S, Altarini, R, Pasi, L,  et al. 1994La prevenzione delle lesioni dei nervi laringei nella chirurgia della tiroideMinerva Chir.49299302PubMedGoogle Scholar
  12. 12.
    Bergamaschi, R, Becouarn, G, Ronceray, J,  et al. 1998Morbidity of thyroid surgeryAm. J. Surg.1767175CrossRefPubMedGoogle Scholar
  13. 13.
    Campana, FP, Marchesi, M, Biffoni, M,  et al. 1996Tecnica della tiroidectomia totale: suggerimenti e proposte di pratica chirurgicaAnn. Ital. Chir.1566576Google Scholar
  14. 14.
    Bondarenko, VO, Ermolov, AS, Magomedov, RB 2001Prophylaxis of laryngeal nerve injuries in thyroid surgeryKhirurgiia (Sofiia).16366Google Scholar
  15. 15.
    Pelizzo, MR, Toniato, A, Gemo, G 1998Zuckerkandl’s tuberculum: an arrow pointing to the recurrent laryngeal nerveJ. Am. Coll. Surg.187333336CrossRefPubMedGoogle Scholar
  16. 16.
    Henry, JF, Audiffret, J, Denizot, A 1988The non recurrent inferior laryngeal nerve: review of 33 cases including two on the left sideSurgery104977984PubMedGoogle Scholar
  17. 17.
    Hemmerling, TM, Schmidt, J, Bosert, C,  et al. 2001Intraoperative monitoring of the recurrent laryngeal nerve in 151 consecutive patients undergoing thyroid surgeryAnesth. Analg.93396399PubMedGoogle Scholar
  18. 18.
    Cernea, CR, Ferraz, AR, Furlani, J,  et al. 1992Identification of the external branch of the superior laryngeal nerve during thyroidectomyAm. J. Surg.164634639PubMedGoogle Scholar
  19. 19.
    Shaha, AR, Jaffe, BM 1994Selective use of drains in thyroid surgeryJ. Surg. Oncol.52241243Google Scholar
  20. 20.
    Campana, FP, Marchesi, M, Tartaglia, F 1992La tiroidectomia totale per gozzoChirurgia (Bucur).5102105Google Scholar
  21. 21.
    Haeger, K 1988Illustrated History of SurgeryAB NordbokGothenburgGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2004

Authors and Affiliations

  • Lodovico Rosato
    • 1
    Email author
  • Nicola Avenia
    • 2
  • Paolo Bernante
    • 3
  • Maurizio De Palma
    • 4
  • Giuseppe Gulino
    • 5
  • Pier Giorgio Nasi
    • 6
  • Maria Rosa Pelizzo
    • 3
  • Luciano Pezzullo
    • 7
  1. 1.Department of Surgery, Endocrine Surgical UnitIvrea HospitalIvreaItaly
  2. 2.Department of Surgery, Endocrine Surgical Unit, Perugia UniversityPoliclinico MontelucePerugiaItaly
  3. 3.Department of Surgery, Endocrine Surgical UnitPadua UniversityPaduaItaly
  4. 4.Department of Surgery, Endocrine Surgical Unit“Cardarelli” HospitalNaplesItaly
  5. 5.Epidemiology clinical-Medical Department OfficeIvrea HospitalIvreaItaly
  6. 6.Department of Surgery, Endocrine Surgical Unit“Umberto I” Mauriziano HospitalTurinItaly
  7. 7.Department of Surgery, Endocrine Surgical UnitI.N.T. “Pascale” HospitalNaplesItaly

Personalised recommendations

Cite article

Buy options