Frequency of Early Post Operative Complications of Thyroidectomy

Abstract

Objective: To determine the frequency of early post operative complications after thyroid gland. 
Study Design: Descriptive case series study. 
Place and Duration of Study: This study was carried out in all four surgical units, Liaquat University Hospital 
Jamshoro, from September 2009 to July 2010. 
Materials and Methods: This study consisted of 100. Detailed History was taken from all the patients with special 
regard to the swelling infront of neck, moving up with deglutition and pressure symptoms like dyspnea, dysphagia, 
engorged neck veins. Detailed Clinical examination of the patient was done and recorded in proforma. Systemic 
review was also done to see any co-morbidity. All patients underwent for base line and specific investigations 
especially TSH, T3 and T4 as diagnostic modality and for assessment of thyroid disease. Inclusion criteria were that 
all patients after counseling for study and taking voluntary consent were included in this study above 15year of age 
and irrespective of their sex admitted in surgical units through outpatient department and diagnosed as case of 
thyroid disease on the basis of history, clinical examination and investigations. Exclusion criteria included unfit 
patients for general anesthesia, previous thyroid surgery, pre-operative recurrent laryngeal or superior laryngeal 
nerve involment and traumatic thyroid injury. Follow up of all these patients was done for period of 6 months . 
Results were prepared with help of tables and graphs.Data was analyzed through SPSS software version 16.0. 
Results: 100 cases of thyroid were operated . Out of 100 patients included in this study 84 were women (84%) and 
16 were male (16%); with male to female ratio of 1:5.2. There was wide variation of age ranging from a minimum 
of 10 years to 70 years with the mean age was  31.78 years . Symptoms of patients were an enlarged painless lump 
infront of neck in 99 (99%), Discomfort during swallowing in 42 (42%), Dyspnea in 38 (38%), Weight loss 52 
(52%), Weight gain in 35 (35%), Bradycardia in 45 (45%), Tachycardia in 55(55%) , Tremors in 41(41%), heat 
Intolerance 43(43%) and cold Intolerance in 20 (20%) (Table 1).  Clinical examination of patients revealed that 
thyroid gland was enlarged in 99 (99%) patients, out of whom 59 (59%) patients had Multinodular goiter, while 30 
(30%) patients had Solitary Nodule (Solid /Cystic), 7 (7%) patients had thyroid cancer and 4 (4%) patients had a 
thyrotoxicosis. The commonest surgical procedure done was subtotal thyroidectomy in 62 patients (62%), near total 
thyroidectomy in 28 patients (28%) and lobectomy with isthmusectomy in 10 patients (10%). The common early 
postoperative complications seen in this study were haematoma formation 9% patients, hypoparathyroidism 3% 
patients , wound infection 6% patients, laryngeal nerve injury 5% patients and thyrotoxicosis storm in 2% patients ( 
Chart No.2).  
Conclusion: We conclude that patients who undergo thyroidectomy an increased risk of developing postoperative 
hypoparathyroidism. Despite the fact that total thyroidectomy is a more involved procedure that exposes more 
parathyroid glands and recurrent laryngeal nerves to surgical risk than unilateral thyroid lobectomy, it is an 
inherently safe procedure.