Complicações pós tireoidectomias: revisão narrativa

Abstract

Introduction: Thyroid disorders are one of the most prevalent endocrine disorders, with thyroidectomy being the most common endocrine surgery for malignant and benign thyroid diseases. Thyroidectomy, despite its effectiveness, is a delicate procedure due to the proximity to important structures, such as the nerves, the lymph nodes and the parathyroid glands. Thus, the incidence of surgical complications is influenced by the extent of the surgery, the thyroid pathology, the anatomical differences, in addition to the surgeon's experience and the association with other procedures. Objective: To carry out a survey regarding the main complications after thyroidectomy and the factors related to the manifestations. Methodology: The literature review was carried out over the months of January and March 2023, through the PubMed, BVS and LILACS databases, using the terms validated by the DeCS “Thyroidectomy”, “Postoperative Complications” and “Postoperative Period”. Results: Eighteen studies were used in the writing of this article after applying the inclusion and exclusion criteria and, subsequently, a table was made with their main findings. Hypocalcemia, hypoparathyroidism and recurrent laryngeal nerve injury are the most common complications after thyroidectomy, the latter being the most serious, with different incidences, causes and prevention. Regarding risk factors, female gender, involuntary parathyroidectomy, parathyroid autograft, surgical extension, and central lymph node dissection were related to a higher incidence of complications. The parathyroid hormone levels were used with predictive value for hypocalcemia and hypoparathyroidism. Conclusion: Thyroidectomy is characterized as a well-established procedure in the medical community, however its approach can bear complications. Studies emphasize hypocalcemia, hypoparathyroidism and recurrent laryngeal nerve injury as the most prevalent, in addition to addressing their causes and risk factors. However, further studies are needed to validate means of prevention to ensure the maintenance of patients' quality of life.