Thyroidectomy: post-operative complications and management
Keywords:Thyroid swellings, Thyroidectomy, Post-operative complications, Hypocalcemia, RLN palsy
Background: Thyroidectomy is a surgical procedure indicated as elective treatment for symptomatic thyroid swellings or neoplasms. Today most of the complications of thyroid surgery are related to either metabolic derangements or injury to the recurrent laryngeal nerve injury. Other complications include superior laryngeal nerve injury, infection, airway compromise, and bleeding. Hence, before any thyroid surgery patient must be precisely informed the possible complications and their remedies. The present study aims to evaluate post-operative complications after thyroid surgery.
Methods: In a tertiary care hospital based longitudinal study patients presenting with clinically and sonographically diagnosed thyroid swelling who underwent surgical intervention were enrolled in the study. These patients were evaluated for thyroid profile test, fine needle aspiration cytology (FNAC), pre-operative and post-operative indirect laryngoscopy, serum calcium level and histopathology. Intra operative and post-operative assessment was done for bleeding, hematoma, and surgical site infection.
Results: A total of 53 patients were enrolled. Thyroid swelling was more common in females (F: M =5.6:1) mostly presenting in 3rd and 4th decades with mean age of 38.1 years. Hemithyroidectomy was the most common procedure performed (63.6%) followed by total (27.3%) and near total thyroidectomies (5.5%). On histopathological examination most common finding was nodular goiter (49.1%) followed by multinodular goiter (28.3%), follicular adenoma (16.9%) and malignancies (5.7%). The post-operative complications after thyroidectomies were hypocalcemia (16.9%), recurrent laryngeal nerve (RLN) injury (5.7%), and surgical site infection (1.9%).
Conclusions: Careful evaluation of post thyroidectomy complications will help in reducing these complications and patient’s safety.
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