Complications after thyroidectomy and the affecting factors related with the surgeon
Selim Sözen1, Seyfi Emir1, Ali Alıcı2, Feridun Aysu2, Fahrettin Yıldız3, Mehmet Aziret1, Mustafa Kısakürek1, Atilla Çakmak2
1Elazığ Eğitim ve Araştırma Hastanesi, Genel Cerrahi, Elazığ, Türkiye
2Şanlıurfa Balıklıgöl Devlet Hastanesi, Genel Cerrahi, Şanlıurfa, Türkiye
3Harran Üniversitesi Tıp Fakültesi, Genel Cerrahi, Şanlıurfa, Türkiye
Purpose: In this study we investigated the complications after thyroidectomy operations performed in our clinic and 7 other clinics, and the affecting factors related with the surgeon.
Patients and Methods: In our study we investigated 265 patients who underwent thyroidectomy between January 2008 and October 2009. and were followed for at least 12 months. The surgeons were classified into two groups as experienced (Group 1), who work in a center performing at least 40 thyroidectomy operations in one year; and less experienced (Group 2), who work in a center performing less than 40 thyroidectomy operations in one year. Experience of the operation team (the surgeon), and duration of the operation were assessed for their effects on paralysis of the vocal cord and hypocalcaemia.
Results: Of the 265 patients 222 (83.7%) were female and 43 (16.3%) were male. Mean age was 44.72±11.32 years. Twelve patients had vocal cord paralysis. Three patients from Group 2 and one from Group 1 experienced seroma and wound infections were observed in both groups. One patient from Group 1 and eleven patients from Group 2 complained about changes in voice. In cases where the operations had lasted longer than 90 minutes, the increase in nerve injury incidence was statistically significant (p=0.03) in group 1. While the effect of the operation team's experience was statistically significant (p=0.005) on the laringeal n.recurrence injury, no statistical significance was noted (p=0.82) on temporary hypocalcaemia. Permanent complication(s) occurred in 3.7% in our series (hypoparathyroidism [n=6] and n. recurrence injuries [n=4] in group 2). Overall, the most frequent complication following thyroidectomy was temporary hypocalcaemia, observed in 6.3% of the patients. It was followed by failure in voice pitching detected in 4.5% of the cases.
Conclusion: Experience, obsession and cautiousness are the most important factors that may decrease the complication risk in total thyroidectomy.
Keywords: Thyroidectomy, complication, hypocalcemia, laryngeal n. recurrence injury