Complications Following Thyroid Surgery

Lee, Kang Dae; Joo, Ho Bum; Lee, Han Kook; Choi, Young Sik; Park, Yo Han

Abstract

BACKGROUND AND OBJECTIVES
Despite the fact that the rate of complications is constantly decreasing, the immediate and severe complications of thyroid surgery emphasize the need for precise surgical techniques and to provide patients with the most benefical treatment that results in lower morbidity. To clarify the safety of thyroid surgery, 147 thyroidectomy cases were reviewed.
MATERIALS AND METHODS
From April 1998 through March 2000, 147 thyroidectomies were performed at the otolaryngologic department. The risk of recurrent laryngeal nerve lesion is based on the number of nerves at risk, and the risk of hypocalcemia is based on the number of patients undergoing bilateral procedures, or contralateral surgery in patients previously operated on. The risk of superior laryngeal nerve injury is based on the number of all thyroidectomies.
RESULTS
The number of nerves at risk was 210. The rate of postoperative permanent recurrent laryngeal nerve palsy was 1.4% (3/210), which is iatrogenic. Four recurrent nerves (1.9%) invaded by cancer were sacrificed intentionally. Transient paralysis was found in 1.4% of the cases (3/210). Transient superior laryngeal nerve injury was found in 0.7% (1/147), all within one month of recovery. Of 89 patients undergoing dissection of both thyroid lobes, 1.1% (1/89) developed postoperative permanent hypocalcemia. Transient postoperative hypocalcemia was found in 7 patients (7.9%), with a recovery period ranging from one to two weeks. Postoperative bleeding, infection, and seroma were not noted in this study.
CONCLUSION
The data strongly indicate that careful surgical techniques, understanding of anatomic variation and surgical experiences hold the clue for a low rate of complications following thyroid surgery.