ABSTRACT
To determine the frequency of early post operative complications after thyroid gland. Descriptive case series study. This study was carried out in all four surgical units, Liaquat University Hospital Jamshoro, from September 2009 to July 2010. This study consisted of 100. Detailed Hisotry 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 15 year 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. 100 cases of thyroid were operated. Out of 100 patients including in this study 84 were women [84%] and 16 were male [16%]; with male to female ratio of 1:52. 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 [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]. 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