Abstract
Background Although thyroidectomy is a common surgical procedure for benign and malignant thyroid diseases, it remains associated with risks such as hypocalcemia and recurrent laryngeal nerve injury. Understanding the frequency and predictors of these complications is essential to improving surgical safety and patient outcomes. This study aimed to evaluate the surgical outcomes and frequency of complications following thyroidectomy in a tertiary care setting. Methodology This retrospective, observational, descriptive study was conducted at Shalamar Hospital, Lahore, Pakistan, from May 2022 to May 2025. A total of 215 patients who underwent thyroidectomy were included in the study. Data were extracted retrospectively from hospital records, operative notes, and discharge summaries. A structured data collection form was used to record patient demographics (age, gender), indication for surgery (benign or malignant pathology), type of thyroidectomy performed, intraoperative findings, and postoperative outcomes. Results Of the 215 patients included, 176 (81.9%) were female and 39 (18.1%) were male, with a mean age of 42.8 ± 11.3 years. Total thyroidectomy was performed in 129 (60.0%) patients, hemithyroidectomy in 54 (25.1%), and subtotal thyroidectomy in 32 (14.9%). Histopathology revealed benign lesions in 134 (62.3%) and malignant lesions in 81 (37.7%) cases. Postoperative complications were observed in 59 (27.4%) patients, with transient hypocalcemia being the most frequent in 39 (18.1%), followed by recurrent laryngeal nerve injury in 14 (6.5%) and wound-related issues. Complication rates were significantly higher in patients undergoing total thyroidectomy (p < 0.05) and those with malignant pathology (p = 0.031). The mean hospital stay was 3.1 ± 1.4 days, which was significantly longer in patients with complications (p < 0.001). Conclusions While thyroidectomy remains an effective treatment for benign and malignant thyroid diseases, the observed complication rate indicates that surgical safety can be further optimized. The relatively high overall complication rate highlights the importance of comprehensive preoperative assessment, precise surgical technique, and structured postoperative monitoring. Strengthening surgeon training, adopting intraoperative nerve monitoring, and standardizing institutional protocols may help reduce complications and improve patient outcomes in similar healthcare settings.