Complications of Thyroid Surgery: Analysis of a Multicentric Study on 14,934 Patients Operated on in Italy over 5 Years

Lodovico Rosato, Nicola Avenia, Paolo Bernante, Maurizio De Palma, Giuseppe Gulino, Pier Giorgio Nasi, Maria Rosa Pelizzo, Luciano Pezzullo

Research output: Contribution to journalArticle

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Abstract

Complication rates associated with thyroid surgery can be evaluated only through analysis of case studies and follow-up data. This study covers postoperative data from 14,934 patients subjected to a follow-up of 5 years. Among them, 3130 (20.9%) underwent total lobectomy (TL), 9599 (64.3%) total thyroidectomy (TT), 1448 (9.7%) subtotal thyroidectomy with a monolateral remnant (MRST), and 757 (5.1%) subtotal thyroidectomy with bilateral remnants (BRST). A total of 6% of the patients had already been operated on. Persistent hypoparathyroidism occurred after 1.7% of all the operations, and temporary hypoparathyroidism was noted in 8.3%. Permanent palsy of the laryngeal recurrent nerve (LRN) occurred in 1.0% of patients, transient palsy in 2.0%, and diplegia in 0.4%. The superior laryngeal nerve was damaged in 3.7%; dysphagia occurred in 1.4% of cases, hemorrhage in 1.2%, and wound infection in 0.3%. No deaths were reported. A significant rate of LRN damage was noted, which has an important impact on the patient's social life. Hypoparathyroidism after total thyroidectomy is an important complication that can be successfully treated by therapy, although it is not always easily managed in special circumstances such as in young persons of pregnant women. The complications associated with thyroid surgery must be kept in mind so the surgeon can carefully evaluate the surgical and medical therapeutic options, have more precise surgical indications, and be able to give the patient adequate information.

Original languageEnglish
Pages (from-to)271-276
Number of pages6
JournalWorld Journal of Surgery
Volume28
Issue number3
DOIs
Publication statusPublished - Mar 2004

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Italy
Thyroidectomy
Thyroid Gland
Hypoparathyroidism
Laryngeal Nerves
Recurrent Laryngeal Nerve
Vocal Cord Paralysis
Wound Infection
Deglutition Disorders
Paralysis
Pregnant Women
Hemorrhage
Therapeutics

ASJC Scopus subject areas

  • Surgery

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Complications of Thyroid Surgery : Analysis of a Multicentric Study on 14,934 Patients Operated on in Italy over 5 Years. / Rosato, Lodovico; Avenia, Nicola; Bernante, Paolo; De Palma, Maurizio; Gulino, Giuseppe; Nasi, Pier Giorgio; Pelizzo, Maria Rosa; Pezzullo, Luciano.

In: World Journal of Surgery, Vol. 28, No. 3, 03.2004, p. 271-276.

Research output: Contribution to journalArticle

Rosato, Lodovico ; Avenia, Nicola ; Bernante, Paolo ; De Palma, Maurizio ; Gulino, Giuseppe ; Nasi, Pier Giorgio ; Pelizzo, Maria Rosa ; Pezzullo, Luciano. / Complications of Thyroid Surgery : Analysis of a Multicentric Study on 14,934 Patients Operated on in Italy over 5 Years. In: World Journal of Surgery. 2004 ; Vol. 28, No. 3. pp. 271-276.
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abstract = "Complication rates associated with thyroid surgery can be evaluated only through analysis of case studies and follow-up data. This study covers postoperative data from 14,934 patients subjected to a follow-up of 5 years. Among them, 3130 (20.9{\%}) underwent total lobectomy (TL), 9599 (64.3{\%}) total thyroidectomy (TT), 1448 (9.7{\%}) subtotal thyroidectomy with a monolateral remnant (MRST), and 757 (5.1{\%}) subtotal thyroidectomy with bilateral remnants (BRST). A total of 6{\%} of the patients had already been operated on. Persistent hypoparathyroidism occurred after 1.7{\%} of all the operations, and temporary hypoparathyroidism was noted in 8.3{\%}. Permanent palsy of the laryngeal recurrent nerve (LRN) occurred in 1.0{\%} of patients, transient palsy in 2.0{\%}, and diplegia in 0.4{\%}. The superior laryngeal nerve was damaged in 3.7{\%}; dysphagia occurred in 1.4{\%} of cases, hemorrhage in 1.2{\%}, and wound infection in 0.3{\%}. No deaths were reported. A significant rate of LRN damage was noted, which has an important impact on the patient's social life. Hypoparathyroidism after total thyroidectomy is an important complication that can be successfully treated by therapy, although it is not always easily managed in special circumstances such as in young persons of pregnant women. The complications associated with thyroid surgery must be kept in mind so the surgeon can carefully evaluate the surgical and medical therapeutic options, have more precise surgical indications, and be able to give the patient adequate information.",
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