Endocrine Abstracts

Background: Patients undergoing thyroid surgery are consented for a 1% risk of permanent hypocalcaemia and voice changes. These complications are considered to be permanent if they persist for more than 6 months. The aim of this study is to determine the incidence of complications in patients undergoing thyroid surgery in our hospital.

Methods: From January 1999 to March 2009, all patients who underwent thyroid surgery under the care of one surgeon were identified from the database. Data on the surgical procedure, indication, final histology and follow-up were recorded from case notes.

Results: Data were recorded on 559 patients who underwent surgery during this period, 498 for benign thyroid disease and 61 for malignancy. Thirty-five patients (6.3%) with benign pathology and 20 (32.8%) with thyroid malignancy had postoperative complications (P=0.0001). Two patients (0.4%) in benign group and one patient (1.64%) with malignancy had permanent hoarseness. Permanent hypocalcaemia was noted in five patients (1.0%) in benign group and one patient (1.64%) in malignant group. The overall incidence of permanent hoarseness and hypocalcaemia was 0.54 and 1.07% respectively.

The incidence was higher in patients over the age of 60 years (17/284 versus 38/275, P=0.002) and in those having completion thyroidectomy (13/50 versus 42/509, P=0.004). Multivariate logistic regression revealed only thyroid malignancy to be significantly associated with postoperative complications (P<0.0001).

Conclusion: The incidence of permanent complications in thyroid surgery is low, patients with thyroid malignancy being at a higher risk. Thyroid surgery appears to be safe in the hands of a general surgeon with a subspecialist interest.