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Observational Study
. 2025 Jul 4;25(1):286.
doi: 10.1186/s12893-025-03018-0.

The BMI impact on thyroidectomy-related morbidity; a case-matched single institutional analysis

Sascha Vaghiri  1 , Jasmin Mirheli  2 , Dimitrios Prassas  3   4 , Stephen Fung  3 , Sami Alexander Safi  3 , Georg Fluegen  3 , Wolfram Trudo Knoefel  5 , Levent Dizdar  3
Affiliations
Observational Study

The BMI impact on thyroidectomy-related morbidity; a case-matched single institutional analysis

Sascha Vaghiri et al. BMC Surg. .

Abstract

Background: Obesity is associated with an increased risk of postoperative morbidity. We aimed to analyze the impact of BMI on surgical complications in patients undergoing thyroidectomy.

Methods: This retrospective study was conducted in a single academic center. A total of 484 patients with open total thyroidectomy were considered eligible. These patients were divided in the non-obese (BMI < 30 kg/m2) and obese (BMI ≥ 30 kg/m2) groups. A 1:2 case matching based on demographic (age and gender) and clinical (benign/malignant disease) variables was performed to generate homogenous study groups. A comparative analysis was carried out to show the differences between the two groups in terms of the occurrence of surgery-related outcomes.

Results: After case matching, 193 non-obese and 98 obese patients were included in the final analysis. There was no statistically significant difference in the rate of primary outcomes in the non-obese and obese groups: hypoparathyroidism (transient: 29% versus 21.4%, p = 0.166; permanent: 11.4% versus 15.3%, p = 0.344, respectively) and recurrent laryngeal nerve palsy (transient: 13.9% versus 11.2%, p = 0.498; permanent: 3.1% versus 2.0%, p = 0.594, respectively). A BMI ≥ 30 kg/m2 was associated with a significantly longer operative time (p = 0.018), while other secondary outcomes were not significantly affected by BMI.

Conclusions: Despite prolonged operative times in obese patients, total thyroidectomy could be performed safely and without increased risk of surgery-related morbidity, regardless of BMI.

Clinical trial number: Not applicable.

Keywords: BMI; Obesity; Postoperative complications; Thyroid surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Institutional Review Board (IRB) approved this study (Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany; study-no.: 2024–2789). All procedures performed in this study were in accordance with the ethical standards of the current version of the Declaration of Helsinki and its later amendments. Patient consent was waived because no data regarding the cases were disclosed (IRB Medical Faculty, Heinrich-Heine-University, Duessledorf). The waiver did not affect the rights and welfare of the subjects, and the research topic was not associated with any risk to the subjects. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart diagram of patient selection and analysis
Fig. 2
Fig. 2
Boxplot visualization of operative times for non-obese and obese patients, * p = 0.032
See this image and copyright information in PMC

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