Assessment of the Morbidity and Complications of Total Thyroidectomy

Bhattacharyya, Neil; Fried, Marvin P.

doi:10.1001/archotol.128.4.389

Cited by 345 publications

(294 citation statements)

References 19 publications

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“…Both in our study and in a study of 34 patients with thyroiditis by Bhattacharyya and Fried, the presence of concomitant lymphocytic thyroiditis with thyroid malignancy was not a risk factor for permanent hypocalcemia [17].…”

Section: Discussionsupporting

confidence: 56%

“…The National Hospital Data Survey database was examined by Bhattacharyya and Fried and in their retrospective study of 517 patients; younger age was statistically associated with an increased incidence of hypocalcemia [17]. In a study of 7,266 patients with benign thyroid disease by Thomusch et al, advanced age was found to be associated with permanent hypocalcemia [6].…”

Section: Discussionmentioning

confidence: 99%

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Permanent hypocalcemia in patients operated for thyroid carcinoma

Turanlı¹,

Karaman

Ozgen

2009

Indian J Otolaryngol Head Neck Surg

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Aim and objective The incidence and risk factors for permanent hypocalcemia in thyroid carcinoma were investigated. Materials and methodsThe records of 417 patients were reviewed retrospectively at tertiary oncology referral center. Total or subtotal thyroidectomy patients constituted group I (n = 225), reoperative thyroid surgery patients constituted group II (n = 106), and therapeutic neck dissection cases constituted group III (n = 86). Age, gender, thyroid functions, pathologically verifi ed tumor type, differentiation, localization and size, multicentricity, thyroid capsule invasion, extrathyroidal soft tissue invasion, coexistence of lymphocytic thyroiditis, metastatic lymph nodes dissected, incidental parathyroidectomy, and the type of surgery were investigated.Re sults Permanent hypocalcemia was seen in 32 (7.7%) patients. The incidence of permanent hypocalcemia for each group was 1.7%, 10.3% and 19.7%, respectively. Related risk factors were hyperthyroidism for group I [adjusted relative risk (RR) = 21.1, 95% confi dence interval (CI) = 2.6-165, p = 0.01] incidental parathyroidectomy for group II (RR = 7.8, 95% CI = 1.9-31.0, p = 0.004), and extrathyroidal soft tissue invasion (RR = 3.1, 95% CI = 1.1-9.5, p = 0.03) for group III.Conclusion Permanent hypocalcemia rate was increased with reoperative thyroid surgery and neck dissection added to total thyroidectomy. Hyperthyroidism, incidental parathyroidectomy and extrathyroidal extension were related risk factors.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Permanent hypocalcemia in patients operated for thyroid carcinoma

Turanlı¹,

Karaman

Ozgen

2009

Indian J Otolaryngol Head Neck Surg

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“…The impact on quality of life as well as clinical presentation of RLN paralysis mainly depends on its severity, unilateral versus bilateral nerve palsy, concomitant injury to superior laryngeal nerve, and baseline status of the vocal cords pre-operatively [15,16]. The range of the clinical severity of RLN palsy may extend from asymptomatic decrease movement of the vocal cords, hoarseness of voice, severe loss of voice, and aspiration to respiratory distress [10,15,16]. Thyroid surgery causing RLN palsy may prompt medico-legal litigations against the surgeon [1,2,17,18].…”

Section: Discussionmentioning

confidence: 99%

Enlargement of “SHENOY Node”: A Risk Factor for Temporary Recurrent Laryngeal Nerve Paralysis after Thyroid Surgery

Dev¹,

Gurawalia²,

A³

et al. 2016

Head Neck Cancer Res

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“…Ayrıca bütün tiroid venlerinin bağlanmış olması da venöz stazın nedenleri arasındadır. Venöz staz ve ödem bir süre için bile olsa da, paratiroid fonksiyonlarını yavaşlatır ve ameliyattan birkaç hafta sonraya kadar devam eden geçici hipoparatiroidiye sebep olabilir (24,25).…”

Section: Discussionunclassified

The Impact of Bilateral Inferior Thyroid Artery Truncal Ligation and Recurrent Laryngeal Nerve Dissection on Early Postoperative Blood Calcium Levels after Total Thyroidectomy

Topal¹,

Gedik²,

Karagöz³

et al. 2014

JAREM

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ÖZETAmaç: Total tiroidektomi yapılan hastalarda, A. thyroidea inferior'un trunkal bağlanıp bağlanmamasının ve N. laryngeus inferior'un diseke edilip edilmemesinin postoperatif erken dönem kan kalsiyumuna etkisi, prospektif randomize olarak araştırıldıYöntemler: "Multinodüler guatr" tanısıyla "total tiroidektomi" endikasyonu alan ve çalışma kriterlerini taşıyan 92 hastada prospektif randomize bir çalışma planlandı. Grup 1'de (n=40) A. thyroidea inferior bilateral trunkal olarak bağlandı ve N. laryngeus inferior diseksiyonu yapıldı. Grup 2'de (n=52) ise A. thyroidea inferior tiroid dokusuna yakın bağlandı ve N. laryngeus inferior diseksiyonu yapılmadı. Tüm hastalarda ameliyattan 12 saat önce ve ameliyattan 1 ve 3 gün sonra kan kalsiyum düzeyleri ölçüldü.Bulgular: Gruplar arasında yaş, cinsiyet, ameliyat süresi ve hastanede kalış süresi açılarından istatiksel olarak anlamlı fark yoktu. İki gruptaki hastaların preoperatif, postoperatif 1. ve 3. gün kan kalsiyum değerleri arasında istatiksel olarak anlamlı fark saptanmadı (sırasıyla p=0,07; p=0,29; p=0,51). Grup 1'de postoperatif 1. gündeki kan kalsiyum değeri (p<0,018), Grup 2'de ise postoperatif 3. gündeki kan kalsiyum değeri (p<0,002) preoperatif değer-lere göre istatistiksel olarak anlamlı düzeyde azalma gösterdi. Buna paralel olarak, postoperatif dönemde Grup 1'de 4 hastada (%10), Grup 2'de ise 5 hastada (%9,5) Chvostek ve Trousseau bulguları ortaya çıktı; bulgular açısından gruplar arasında istatistiksel olarak fark saptanmadı (p=0,71). Hiçbir olguda ses kısıklığı ve/veya solunum güçlüğü gözlenmedi. Sonuç:A. thyroidea inferior'un trunkal bağlanması ve N. laryngeus inferior'un diseke edilmesi, arterin dokuya yakın bağlanması ve sinirin diseke edilmemesine göre postoperatif kan kalsiyum değerini anlamlı düzeyde etkilememiştir. Her iki yöntem de benzer ve beklenebilir oranda (%10) postoperatif erken dönem hipokalsemisi ortaya çıkmıştır. Her iki yöntemde de tiroidektomi sonrası görülebilen ses kısıklığı ve solunum güçlüğü gibi major komplikasyonlar ortaya çıkmamıştır. (JAREM 2014; 2: 69-73) Anahtar Sözcükler: Total tiroidektomi, tiroid inferior arter, laringeal inferior sinir, trunkal arter ligasyonu, sinir diseksiyonu ABSTRACT Objective: Early postoperative calcium levels were evaluated following total thyroidectomy with respect to bilateral inferior thyroid artery truncal ligation and reccurent laryngeal nerve dissection.Methods: Ninety two patients with multinodular goitre were treated with total thyroidectomy, and randomised according to the study protocol. Bilateral inferior thyroid artery truncal ligation together with dissection of recurrent laryngeal nerve was performed in group 1 (no:40). In group 2 patients (n:52), Inferior thyroid artery was ligated at the level of the thyroid gland entrance and dissection of nervus laryngeus inferior was not performed. The calcium levels were obtained 12 hours before and 24.72 hours after the operation.Results: There were no significant differences in age, gender, operating time and hospitalisation time between the t...

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Assessment of the Morbidity and Complications of Total Thyroidectomy

Abstract: Postoperative hypocalcemia is the most common immediate surgical complication of total thyroidectomy. Other complications, including recurrent laryngeal nerve paralysis, can be expected at rates approximating 1%.

Cited by 345 publications

References 19 publications

Permanent hypocalcemia in patients operated for thyroid carcinoma

Permanent hypocalcemia in patients operated for thyroid carcinoma

Enlargement of “SHENOY Node”: A Risk Factor for Temporary Recurrent Laryngeal Nerve Paralysis after Thyroid Surgery

The Impact of Bilateral Inferior Thyroid Artery Truncal Ligation and Recurrent Laryngeal Nerve Dissection on Early Postoperative Blood Calcium Levels after Total Thyroidectomy

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