Thyroidectomy for benign thyroid diseases: Evaluation of surgical methods and the complications
Kasım Çağlayan1, Atilla Çelik2
1Bozok Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Yozgat, Türkiye
2Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, 2. Genel Cerrahi Kliniği, İstanbul, Türkiye
Purpose: Temporary or permanent hypocalcemia and recurrent nerve injury are important complications after thyroid surgery. These complications extend the duration of hospitalization and affect the patient's comfort. The aim of this study is to investigate the complications and the risk factors affecting them in patients who have underwent surgical procedures for benign thyroid disease.
Materials and Methods: Records belonging to 242 patients who have underwent surgery for benign thyroid disease between September 2004 and December 2008 are retrospectively analyzed. The impact of age, gender, surgical procedures, ultrasonographic findings and presence of malignancy detected in the specimens and preoperative hormonal status over emerging complications were investigated
Results: The mean age of the 242 cases included in study was 38 years (15-78), with a female to male ratio of 217/25 (89.7%). When the type of the surgery was examined, it was observed that 106 (43.8%) patients had bilateral total thyroidectomy, 57 (23.6%) patients had bilateral subtotal thyroidectomy, 59 (24.4%) patients had nearly-total thyroidectomy and 20 (8.2%) patients had unilateral lobectomy. No postoperative complications were observed in 195 patients (80.6%). When complications were classified, 25 patients (10.3%) had transient hypocalcaemia, 17 (7.0%) patients had temporary recurrent nerve palsy, three (1.2%) patients had permanent hypocalcaemia and two (0.9%) patients developed permanent recurrent nerve palsy.
Conclusion: We have not observed any statistically significant relationship between complication rates and the surgical procedures performed in benign thyroid disease. However, there was a high rate of recurrence after bilateral subtotal thyroidectomy and completion thyroidectomy may be necessary in cases who have a malignancy at the final pathology. Therefore, we suggest that bilateral total thyroidectomy or near total thyroidectomy should be more appropriate as a method of surgery in benign thyroid disease.
Keywords: Benign thyroid disease, complications of thyroidectomy, thyroidectomy