Background and Aim
During recent years, more radical surgery for thyroid disease, i.e., total instead of subtotal resection, has been evident.
Results following this strategy on national levels are scarce.
Materials and methods
From 2004 to 2006, 26 Scandinavian Departments registered 3,660 thyroid operations in a database. Risk factors for complications
were analyzed with multiple logistic regression.
Results
After thyroidectomy, re-bleeding occurred in 2.1% and was associated with older age (OR 1.04; p < 0.0001) and male gender (OR 1.90; p = 0.014). Postoperative infection occurred in 1.6% and associated with lymph node operation (OR 8.18; p < 0.0001). Postoperative unilateral paresis of the recurrent laryngeal nerve was diagnosed 3.9% and bilateral paresis in
0.2%. Unilateral paresis was associated with older age, intrathoracic goiter, thyreotoxicosis, and if routine laryngoscopy
was practiced (OR 1.92; p = 0.0002). After 6 months, the incidence of nerve paresis was 0.97%. After bilateral thyroid surgery (n = 1,648), hypocalcaemia treated with vitamin D analogue occurred in 9.9% of the patients at the first follow-up and in 4.4%
after 6 months.
Conclusion
Complications to thyroid surgery are not uncommon. The high frequency of hypocalcaemia treated with vitamin D after 6 months
is a cause of concern.
Keywords Thyroid - Surgery - Complications - Audit - Database
S. Jansson, A. Kristoffersson, H. Mårtensson, E. Reihnér, G. Wallin and I Lausen are all members of the Steering Committee
for the Scandanavian Quality Register for Throid and Parathyroid Surgery.
Presented at the 3rd Biennial Congress of the European Society of Endocrine Surgeons, Barcelona, April 24–26, 2008.
Best of Endocrine Surgery in Europe 2008.