Post Thyroidectomy Complications- Our Experience in Tertiary Care Hospital

Abstract

BACKGROUND Thyroidectomy is a very common surgical procedure worldwide and is performed by surgeons with varied training. The outcome and complication rates are largely dependent on surgeon's skill and experience, the extent of surgery, indication of surgery and number of thyroid surgeries performed at that particular centre. The objective of this study is to determine the frequency of postoperative complications after thyroid surgery in a tertiary care hospital, Vishakhapatnam. The purpose of this study is to assess the early complications of total thyroidectomy and risk factors which leads to these complications. MATERIALS AND METHODS It was a retrospective descriptive study and was carried out over a period of 3 years from January 2014 to December 2017. A total of 179 patients of thyroid swelling, who underwent total thyroidectomy are assessed over a period of 3 years. All patients with thyroid swelling who underwent total thyroidectomy irrespective of cause of thyroid swelling were included in this study. Patient's biodata including age, sex, clinical status of thyroid, thyroid function tests, ultrasound, fine needle aspiration cytology and operative procedure, findings, post-operative complications and histopathology were recorded. RESULTS A total of 179 cases of thyroid swelling who underwent total thyroidectomy were assessed. The overall post-operative complication rate was 20.11% (36 cases). Post-operative hypocalcaemia was the most frequent complication observed in 33 cases. Most of the hypocalcaemia is transient in immediate post-operative period; permanent being observed in 4 cases. Recurrent laryngeal nerve (RLN) injury was noted in 10 (5.5%) patients. The complications like bleeding leading to haematoma formation was observed in one case for which immediate exploration was done; seroma formation in 15 cases. Tracheal and oesophageal injuries were identified in 5 and 2 cases respectively, which were due to extensive infiltration of these structures by malignant thyroid disease. Complications like wound infection, superior laryngeal nerve injury and sympathetic chain injury were not observed in our study. Many patients had more than one complication.