Morbidity following thyroid surgery: acceptable rates and how to manage complicated patients
- 63 Downloads
The endocrine surgeon and the endocrinologist should standardize how they deal with patients with an indication for thyroidectomy, as the road to surgery starts well before the operation itself. The patient should be thoroughly informed about where and how surgery will be performed, the postoperative improvements that can be expected, and the possibility and incidence of relevant complications. This short review aims at identifying the most common postoperative issues after thyroidectomy, with the relevant therapeutic suggestions.
A revision of studies reporting the morbidity of thyroid surgery, involving the largest numbers of patients.
It has been clearly demonstrated that the outcome of thyroid surgery is significantly better when the procedure is performed by an experienced surgeon. Thus, the number of thyroidectomies performed by a surgeon should drive the endocrinologist when referring a patient.
Despite the surgeon's experience, thyroidectomy is burdened by a relatively high rate of postoperative issues ranging from less severe ones to others causing significant changes in the patient’s quality of life. Minor, non-invalidating symptoms have been described in 40% of patients after thyroidectomy (e.g. hoarseness, mild dysphagia, some degree of voice alteration); however, these symptoms usually resolve within a few months of surgery, with or without early treatment. On the other hand, major postoperative complications are observed in a limited number of patients, but in these cases early diagnosis is important to provide the most appropriate postoperative treatment, and thus hasten full recovery or at least achieve the greatest possible improvement.
KeywordsThyroid surgery Thyroidectomy Morbidity Hypoparathyroidism Dysphonia Dysphagia
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Human participants and/or animals
This review does not involve human participants and/or animals.
This review did not need any informed consent.
- 5.de Pedro Netto I, Fae A, Vartanian JG et al (2006) Voice and vocal self-assessment after thyroidectomy. Head Neck 28(12):1106–1114Google Scholar
- 11.Varaldo E, Ansaldo GL, Mascherini M et al (2014) Neurological complications in thyroid surgery: a surgical point of view on laryngeal nerves. Front Endocrinol (Lausanne) 15(5):108Google Scholar
- 23.Cirocchi R, Arezzo A, D’Andrea V et al (2019) Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery. Cochrane Database Syst Rev 19(1):CD012483Google Scholar
- 31.Orloff LA, Wiseman SM, Bernet VJ et al (2018) American thyroid association statement on postoperative hypoparathyroidism: diagnosis, prevention, and management in adults. Thyroid 28(7):830–841Google Scholar