ABSTRACT
Background: Postoperative complications after thyroidectomy are problematic for patients and surgeons. The postoperative outcome of thyroidectomies is related to risk factors concerning the patient, the thyroid disease and the surgeon
Objective: To analyze the risk factors for postoperative complications after thyroidectomy in patients of simple multinodular goiter
Methodology: A prospective study was conducted in Surgical unit of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan on 114 patients diagnosed and surgically treated for simple multi nodular goitre [MNG] between 1[st] July 2012 and 30 June[th] 2014 meeting the following criteria: bilateral MNG; operation by surgeons with experience in endocrine surgery; no associated parathyroid pathology; no initial thoracic approach; and minimum follow-up of 6 months. Age, sex, time of evolution of symptoms, thyroid weight, recurrent goiter and type of surgery [total thyroidectomy or near total thyroidectomy] were analyzed as risk factors for complications. Data was analyzed using SPSS version 16.0. P-values < 0.05 were considered statistically significant
Results: During the study period 114 thyroidectomies were performed. There were 20 [17.5%] males and 94 females [82.5%] with age of 48.5 +/- 13.6 years. Male to female ratio was 1:4.7. Total thyroidectomy performed in 57[50%] patients and near total thyroidectomy was also performed in 57[50%] patients. Total complications occurred was 29 [25.43%] in 114 patients. Transient hypoparathyroidism was the major complication seen in 17 [14.9%] patients and permanent hypoparathyroidism was seen in 3[2.6%] patients. 3[2.6%] patients suffered from transient recurrent laryngeal nerve palsy [RNLP] and 2 [1.8%] patients suffered from permanent RNLP. Hematoma formation was present in 3[2.6%] patients and wound infection was present in 1[0.9%].There was significant association of transient hypoparathyroidism with duration of goiter [p-value=.016], presence of compressive symptoms [p-value= 0.000] and type of surgery [p-value=.017]. Permanent hypoparathyroidism was significantly associated with recurrence of goiter [p-value=.02]. Permanent RNLP was significantly associated with compressive symptoms [p-value=.007]. There was no significant between hematoma formation and risk factors. So duration of goiter, presence of compressive symptoms, weight of thyroid gland, type of surgery and recurrence were the significant risk factors for complications in patients of simple MNG
Conclusion: In conclusion duration of goiter, presence of compressive symptoms, recurrence of goiter and surgical resection are significant factors for post thyroidectomy complications. By performing early surgery and total thyroidectomy complications rate can be reduced