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Observational Study
. 2021 Sep 25;21(1):352.
doi: 10.1186/s12893-021-01353-6.

Adverse events in thyroid surgery: observational study in three surgical units with high volume/year

Paolo Del Rio  1 , Paolo Carcoforo  2 , Fabio Medas  3 , Elena Bonati  4 , Tommaso Loderer  1 , Margherita Koleva Radica  2 , Piergiorgio Calò  3
Affiliations
Observational Study

Adverse events in thyroid surgery: observational study in three surgical units with high volume/year

Paolo Del Rio et al. BMC Surg. .

Abstract

Background: Thyroid surgery, performed for benign or malignant pathologies, is one of the most frequently performed procedures and its frequency has even been increasing in recent years. Postoperative bleeding, recurrent laryngeal nerve (RLN) palsy, associated to dysphonia, dysphagia, dyspnea, and hypoparathyroidism represent the most fearful and common complications. We conducted a multicenter, observational study of retrospectively collected data in three high-volume referral centers, enrolling all patients undergone to thyroid surgery between January 2016 and December 2017 in Parma University Hospital, Cagliari University Hospital and Ferrara University Hospital.

Materials: Patients were divided into five groups, differentiated thyroid carcinoma, medullary thyroid carcinoma, non-toxic benign pathology, hyperfunctioning benign pathology and NIFTP (Non-invasive Follicular Thyroid neoplasm with Papillary-like nuclear features). A follow up at 7 and 30 days was executed, evaluating the onset of paresthesia, dysphonia and dysphagia. A 6-month follow-up was conducted in cases of early complications.

Results: Totally, 1252 patients were eligible for the study: 907 female and 345 male, with a female to male ratio of 2.6:1 and an average age of 53.428. Total thyroidectomy was performed in 1022 cases, lobectomy in 230. After 6 months we recorded paresthesia in 0.5%, dysphonia in 1.8% and dysphagia in 0.5%.

Conclusion: Our study confirms once again that a share of morbidity escapes the possibilities of prediction and control by the operator, depending on patient anamnestic, pathological or anatomical factors.

Keywords: Dysphonia; Hypocalcemia; Postoperative bleeding; Thyroidectomy; Vocal cord palsy.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Forest plot reporting results of multivariate analysis considering postoperative dysphonia as dependent variable. OR odds ratio, HBP high blood pressure, IO intraoperative, ACT/AAG anticoagulant/antiaggregant, LND lymph node dissection, LOS loss of signal, IONM intraoperative nerve monitoring, DTC differentiated thyroid carcinoma. X axis is reported in logarithmic scale
Fig. 2
Fig. 2
Forest plot reporting results of multivariate analysis considering postoperative bleeding as dependent variable. OR odds ratio, HBP high blood pressure, ACT/AAG anticoagulant/antiaggregant, IO intraoperative, LND lymph node dissection. X axis is reported in logarithmic scale.
Fig. 3
Fig. 3
Forest plot reporting results of multivariate analysis considering postoperative paraesthesia as dependent variable. OR odds ratio, HBP high blood pressure, ACT/AAG anticoagulant/antiaggregant, LND lymph node dissection, POD1 postoperative day 1, PG parathyroid glands. X axis is reported in logarithmic scale.
See this image and copyright information in PMC

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