Incidence of Complications in Operations on Thyroid Gland.
A Retrospective Analysis

Czech version

Authors: J. Lukáš ^1,2; J. Astl ¹; J. Paska ¹; P. Jirák ¹; J. Traboulsi ¹; J. Štěpánek ¹; Michal Černý ¹ ; J. Svárovský ¹; J. Kačírková ¹
Authors‘ workplace: Oddělení ORL a chirurgie hlavy a krku, Nemocnice Na Homolce, Praha ¹; Otorinolaryngologická klinika, Lékařská fakulta UK v Plzni ²
Published in: Otorinolaryngol Foniatr, 66, 2017, No. 2, pp. 66-70.
Category: Original Article

Overview

Introduction:
Thyroidectomy belongs to most frequently performed operations in endocrinology surgery. The operations and potentially associated with the risk of complications, which may cause lifelong health consequences. The aim of the study was to analyze incidence of postoperative pareses of recurrent nerve and hypocalcemia.

Material and methods:
Retrospective analysis of patients operated on over the period of ten years included, in addition to sex, age, representation of benign diseases and malignant tumors, the number of performed operations, also the incidence of postoperative paresis of recurrent nerve (NLR) and hypocalcemia. For an objective comparison of the results of surgical therapy from the standpoint of incidence of NLP pareses the index of recurrent injury (IRI index) was determined. The surgeons were divided into four groups according to number of performed operations and the incidence of complications was analyzed there.

Results:
A total of 1334 patients at the average age of 52.5 years, 1113 of them were women (83.4%). Malignant tumors were diagnosed in 227 patients (17%), 222 of them were carcinomas (97.8%). Total thyroidectomy was performed in 1067 patients (80%) and hemithyroidectomy included 267 patients (20.0%). A unilateral paresis of recurrent nerve affected 1.4% of patients with malignant tumors and 0.7% of those with a benign disease (p=0.045). Permanent hypocalcemia affected 2% of patients with malignant tumors and 0.7% of those with a benign disease (p=0.011). The highest incidence of complications were encountered with medium advanced surgeons, permanent hypocalcemia affected 4.2% of the patients and unilateral paresis of recurrent nerve in 2.8% of the patients undergoing surgery.

Conclusion:
Results of the analysis confirm that postoperative complications are comparable with the large respected centers. The knowledge and experience of a thyroidal surgeon represent a higher guarantee of the intervention safety than the selection of a minimally radical surgery.

KEYWORDS:
total thyroidectomy, block cervical dissection, paresis of recurrent laryngeal nerve, hypocalcemia

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