Endocrine Abstracts

Background: Surgery remains the mainstay of treatment for both benign and malignant thyroid disease. Permanent hypoparathyroidism and recurrent laryngeal nerve injury are the two most commonly occurring complications post thyroid surgery. The aim of this study is to determine the risk factors for developing post-operative complications.

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 was recorded from medical notes.

Results: The study included 559 patients out of which 391 patients underwent total thyroidectomy, 118 had hemithyroidectomy and 50 had completion total thyroidectomy. Fifty-five patients had postoperative complications, 17 of which were <60 years and 38 were more than 60 years old (P=0.002). 35/498 patients with benign disease and 20/61 with thyroid malignancy had postoperative complications (P=0.0001). Two patients in benign group and one patient in malignant group had permanent hoarseness (P=0.29), whereas five patients in benign group and one patient with malignancy had permanent hypocalcaemia (P=0.50). 22/119 patients with compressive symptoms and 33/440 with non-compressive symptoms had postoperative symptoms (P=0.564). The incidence was significantly higher in completion thyroidectomy as compared to total thyroidectomy and thyroid lobectomy (P=0.0004). Multivariable logistic regression identified only thyroid malignancy to be significantly associated with postoperative complications (P<0.0001).

Conclusion: The risk of postoperative complication is significantly higher in malignant cases. On multivariate analysis, age, symptoms and the type of procedure did not have statistically significant association with postoperative complications.