Elsevier

American Journal of Otolaryngology

Volume 25, Issue 4, July–August 2004, Pages 225-230
American Journal of Otolaryngology

Postoperative complications of thyroidectomy for differentiated thyroid carcinoma

https://doi.org/10.1016/j.amjoto.2004.02.001Get rights and content

Abstract

Objective

This study evaluates the incidence and risk factors of complications in patients submitted to thyroidectomy for differentiated thyroid carcinoma in a cancer hospital with residency training.

Study design

A retrospective chart and complications review of 316 consecutive patients who underwent thyroidectomy for differentiated thyroid carcinoma.

Results

Of the 316 patients, the main postoperative complications were transient hypocalcemia in 87 (27.5%), permanent hypocalcemia in 16 (5.1%), transient vocal cord palsy in 4 (1.2%), and permanent vocal cord palsy in 2 (0.6%). Neck dissection and paratracheal lymph node dissection when associated with total thyroidectomy were significantly related to transitory and permanent hypocalcemia.

Conclusion

Thyroid surgery can be performed safely in a hospital with medical residency training program under direct supervision of an experienced surgeon with acceptable morbidity. Hypocalcemia is the most significant complication. Neck and paratracheal lymph node dissections were the most significant predictors of hypocalcemia in patients submitted to total thyroidectomy.

Section snippets

Patients and methods

From January 1990 to December 2000, 1020 patients were submitted to thyroidectomy in the Head and Neck Surgery and Otorhinolaryngology Department of the Centro de Tratamento e Pesquisa Hospital do Câncer A C Camargo, in São Paulo, Brazil. The vast majority of the operations were performed by third- to fifth-year medical residents under direct the supervision of 10 different experienced head and neck surgeons. The attending surgeons were stratified as follows according to the total number of

Results

One hundred twenty-three patients (38.9%) had postoperative complications, with hypocalcemia as the most frequent one. Other less frequent complications were vocal fold palsy, hematoma, seroma, and wound infection (Table 1). The mean duration of hospital stay was 2 days (ranging from 1 to 18 days). Thyroidectomies were performed or supervised by surgeons classified as follows according to the number of thyroidectomies: group A (22%), group B (18%), and group C (60%).

The overall rate of vocal

Discussion

Thyroidectomy is a very common surgical procedure worldwide and is performed by surgeons with varied training and backgrounds such as general surgery, thoracic surgery, endocrine surgery, otorhinolaryngology, oncologic surgery, and head and neck surgery. Our department is part of an oncological surgery training program, where most of such operations are performed by 3rd to 5th year medical residents in surgical oncology or head and neck surgery fellows under the direct supervision of one

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