Atul Uttamrao Yadgire
Introduction : Major postoperative complications of thyroid surgeries include wound infection, hematoma/ hemorrhage causing airway compromise, hypocalcemia, recurrent or superior laryngeal nerve injury, and thyroid storm. Precise knowledge of the intricate anatomic details and meticulous surgical technique are prerequisite determinants for successful outcomes and to keep complications within acceptable limits. The aim of this study was to assess the incidence of different complications of various thyroid surgeries done for benign as well as malignant thyroid disorders in local secondary & tertiary care centres.
Methods: This was a Retrospective analytical study. Case sheets / files of 100 patients were selected which were proven cases of malignant or benign thyroid disorders which were admitted in the last 24 months within the randomly selected local secondary & tertiary care hospitals were included in the study.
Results: Preoperative diagnosis of benign and malignant pathologies was made in 89 and 11 % cases respectively. Most common pathological diagnosis observed was colloid goiter (multinodular goiter, MNG) occurring in 45% of cases, whereas papillary carcinoma accounting for 11 % was the commonest malignant lesion. The overall postoperative complication rate was 18%. Hypocalcemia ( 8%, both temporary and permanent ) and recurrent laryngeal nerve injury ( 6% , both temporary and permanent ) were observed as the most common postoperative complication.
Conclusion: Hypoparathyroidism and RLNI are the commonest complications observed after thyroidectomies. Attempts must be made to identify and preserve parathyroid glands to avoid HPT. It is of paramount importance for careful postoperative observation and timely intervention should the hypocalcemia develop and manifest. Recurrent and superior laryngeal nerve injury can be prevented by correctly identifying and following these nerves.
Key Word : thyroidectomy , Thyroid Nodule , Hypocalcaemia , RLNI