Adverse events in thyroid surgery: observational study in three surgical units with high volume/year

Abstract

Background Thyroid surgery, performed for benign or malignant pathologies, is one of the most frequently performed procedures and its frequency has even been increasing in recent years. Postoperative bleeding, recurrent laryngeal nerve (RLN) palsy, associated to dysphonia, dysphagia, dyspnea, and hypoparathyroidism represent the most fearful and common complications. We conducted a multicenter, observational study of retrospectively collected data in three high-volume referral centers, enrolling all patients undergone to thyroid surgery between January 2016 and December 2017 in Parma University Hospital, Cagliari University Hospital and Ferrara University Hospital. Materials Patients were divided into five groups, differentiated thyroid carcinoma, medullary thyroid carcinoma, non-toxic benign pathology, hyperfunctioning benign pathology and NIFTP (Non-invasive Follicular Thyroid neoplasm with Papillary-like nuclear features). A follow up at 7 and 30 days was executed, evaluating the onset of paresthesia, dysphonia and dysphagia. A 6-month follow-up was conducted in cases of early complications. Results Totally, 1252 patients were eligible for the study: 907 female and 345 male, with a female to male ratio of 2.6:1 and an average age of 53.428. Total thyroidectomy was performed in 1022 cases, lobectomy in 230. After 6 months we recorded paresthesia in 0.5%, dysphonia in 1.8% and dysphagia in 0.5%. Conclusion Our study confirms once again that a share of morbidity escapes the possibilities of prediction and control by the operator, depending on patient anamnestic, pathological or anatomical factors.

Prevalence of Central Compartment Lymph Node Metastases in Papillary Thyroid Micro-Carcinoma: A Retrospective Evaluation of Predictive Preoperative Features

“…This restriction is largely due to the high postoperative complications rate after thyroid surgery plus lymph node dissection performed in centers with limited experience. Indeed, in high-volume centers, it seems that prophylactic central lymph node dissection doesn’t influence the postoperative complications rate, as confirm our results and other published papers [ 67 , 68 , 73 , 74 , 75 ].…”

Risk of Complications in Patients Undergoing Completion Thyroidectomy after Hemithyroidectomy for Thyroid Nodule with Indeterminate Cytology: An Italian Multicentre Retrospective Study

“…Morbidity is mainly represented by hypoparathyroidism, recurrent laryngeal nerve injury, cervical haematoma and wound infection. These complications lead to a reduction in the quality of life of the patients and increased costs for healthcare systems [24][25][26][27][28][29][30][31][32][33].…”

Unilateral Thyroid Lobectomy as Day Care Procedure: A Cross Sectional Study with Literature Review on the Safety and Cost Effectiveness

“…Thyroid nodule is a common pathological entity that is found globally in almost one fifth of the adult population. 1,2 Asymptomatic nodules have an incidence ranging from almost 19 to as high as 68% as accidental finding on ultrasound. A gender based discrepancy of prevalence of palpable thyroid nodules exists, in which a prevalence of 1% is found in the male population in comparison to 5% in the female population.…”

“…4 5 6 The frequency of thyroidectomy has increased secondary to the increase in prevalence of thyroid carcinoma globally. 2 Previously, a 10.7% morbidity rate was reported after thyroidectomy but, according to Lombardi et al, the mortality rate has gone down to essentially 0% and morbidity rates have declined to 3%; 5 whereas the mortality rate after thyroid lobectomy according to British association of endocrine and thyroid surgeons (BAETS) is 0.2%, majorly secondary to hematoma. 7 In a US-based study, the rate of postoperative hematoma after thyroid surgery was 1 to 2.3% 8 9 Similar assertions have been made across the literature to ensure and promote day care surgeries as a viable option.…”