Clinical study of postoperative complications of thyroidectomy

Abstract

Background: Thyroid surgery is one of the common surgeries performed by general surgeons, Head and neck surgeons, and endocrine surgeons today. The most common complications of thyroid surgery are bleeding, injury to recurrent laryngeal nerves, and parathyroid glands. Other complications include airway obstruction, superior laryngeal nerve injury, infections, and sometimes thyroid crisis. Patients with permanent recurrent laryngeal nerve palsy and hypocalcaemia have life-long problems with a need for continued medication, further surgeries, and rehabilitation. They have a compromised quality of life by an increase in individual's healthcare costs and requiring lifelong alternative therapies. Objectives: To evaluate the incidence of post thyroidectomy complications. It also intends to evaluate the preoperative and intra-operative factors that contribute to these complications. To assess the modalities to prevent such complications. Methods: A Prospective study was done from January 2018 to December 2019 on thyroid complications. A total of 78 patients were studied regarding the diagnosis, type of surgery, and the complications in them. The patients were followed up for 1 year. Results: The majority of patients (59%) were in the 3rd and 4th decade of life age. Female domination more than male. Multinodular goiter is the most common diagnosis. The most common complication was transient Hypocalcaemia (15.38%) and recurrent laryngeal nerve( 6.41%). Wound infections in 6.41%and seromas are 2.56%. The incidence of major bleed with respiratory obstruction and thyrotoxicosis is zero. No permanent debilitating complications of RL nerve injury or hypocalcaemia were noted. Conclusion: A thorough preoperative preparation, with adequate knowledge of Thyroid anatomy and steps of surgery is essential. A clean dissection, meticulous haemostasis and, identification and preservation of Recurrent Laryngeal and Parathyroids can relate to a low rate of complications. Extensive surgeries are associated with a higher rate of complications. Early recognition and prompt treatment of complications enable a better outcome for the patient.