An Audit of the Procedure of Open Thyroidectomy at A Tertiary Care Centre.

Indian J Otolaryngol Head Neck Surg

Present Address: Department of ENT and Head and Neck Surgery, AIIMS, New Delhi, 110029 India.

Published: October 2022

We plan to evaluate the various variables associated with the complications of thyroidectomy performed at our department in the last 5 years. Medical records of the patients who underwent thyroidectomy during 2014-2018 were collected. Complications of hypocalcemia and recurrent laryngeal nerve palsy were analysed in terms of the demography, cytopathology and the extent of surgery. Student's -test, Mann-Whitney -test, Fisher exact test and chi square test were applied to look for any significant associations. P value < 0.05 was considered significant. 123 patients were analysed (87 females, 38 males). Mean age was 38.3 years (range 11-71 years). Most common cytopathology was papillary carcinoma thyroid (Bethesda VI) - 43/123 (35%). 107 of these 123 patients underwent primary surgery, 10 underwent revision surgery while 6 underwent completion thyroidectomy. Seven patients incurred RLN palsy out of which 3 were temporary. RLN palsy was seen in only malignant cases ( < 0.05). Incidence was higher in T4a stage ( < 0.05). However, it had no association with a simultaneous central or lateral neck dissection. Hypocalcemia was seen in 22 patients (17.8%), out of whom 9 patients developed permanent hypocalcemia. It was seen significantly higher in patients undergoing central neck dissection ( < 0.05) and in malignant thyroid lesions ( < 0.05). Gender, age and the cytopathology had no bearing on RLN palsy and hypoparathyroidism. Malignant thyroid lesions had a significantly higher incidence of RLN palsy and hypoparathyroidism. A thorough anatomical knowledge can reduce the incidence of these complications.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9702095PMC
http://dx.doi.org/10.1007/s12070-020-02128-wDOI Listing

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