Surgical outcomes and complications of completion thyroidectomy: a retrospective study

甲状腺全切术的手术结果和并发症:一项回顾性研究

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Abstract

This study aims to evaluate the surgical outcomes and complications of completion thyroidectomy (CT) in patients who previously underwent lobectomy with istmhectomy (LI) or subtotal thyroidectomy (ST). The study also seeks to identify patient groups that benefit from CT and examine the risks associated with this procedure. A retrospective analysis was conducted on 70 patients who underwent completion thyroidectomy in our General Surgery Clinic between January 2015 and July 2023. Patients who had previously undergone thyroid surgery due to thyroid malignancy or benign goiter were included in the study. Demographic data, initial pathology, surgical procedures, postoperative complications, and histopathological findings were analyzed. Postoperative complications, including hypoparathyroidism, recurrent laryngeal nerve injury, hematoma, and the need for tracheostomy, were recorded and compared between groups. Based on prior surgical history, 18 patients (25.7%) had previously undergone LI, while 52 patients (74.3%) had undergone subtotal thyroidectomy (ST). The overall complication rate was significantly higher in the ST group (36.5%) compared to the LI group (11%) (p = 0.04). A significant association was found between larger nodule size and higher complication rates (p = 0.03). Postoperative histopathological examination revealed malignancy in 18.5% of patients, with no significant difference between the groups in terms of histopathological findings. This study highlights the increased risk of complications, particularly hypoparathyroidism and recurrent laryngeal nerve injury, in patients undergoing completion thyroidectomy after subtotal thyroidectomy. However, no significant differences were found between the groups regarding malignancy rates and histopathological findings. Further studies with larger patient populations and long-term follow-ups are needed to better understand the clinical benefits and risks of CT.

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