Source: J Nucl Med  |  Posted 9 years ago

Hypocalcaemia is the most frequent immediate post-operative complication in patients who have undergone total thyroidectomy. Recurrent laryngeal nerve paralysis, among other complications, may occur at a rate of 1 percent.

This was the finding following research undertaken by Otolaryngologists at Harvard Medical School, and Brigham and Women's Hospital in Boston, Massachusetts and the Montefiore Medical Center, Bronx, New York, United States, designed to determine the incidence and predictive factors relative to postoperative total thyroidectomy.

Having examined the database of the National Hospital Data Survey, researchers selected 517 patients (mean age 48.3 years) who had undergone this surgical process between 1995 and 1999. They then identified essential information relative to demographic information, and postoperative complications, exemplified by hypocalcaemia, recurrent laryngeal nerve paralysis, wound complications and medical morbidity. In addition, potential predictive factors for complication were undertaken through statistical analysis.

A total of 73.9 percent of all cases required total thyroidectomy for either a goitre or malignancy. An associated nodal dissection was undertaken together with a total thyroidectomy in 81 patients, and parathyroid implantation was performed in 16 patients. Their mean postoperative length of stay was 2.5 days, and this was unaffected by postoperative hypocalcaemia.

Researchers identified an incidence rate of 1 percent for postoperative wound haematoma, a 0.2 percent wound infection and mortality rate. The incidence of hypocalcaemia was 6.2 percent, which was also statistically associated with a younger age group. However, they further established that gender, surgical indication, and parathyroid reimplantation and associated neck dissection had no association with the younger subjects. Unilateral and bilateral vocal chord paralysis was established at rates of 0.77 percent and 0.39 percent respectively.