Our Summary

This research paper is about a study that was done to understand the frequency of complications after the surgical removal of the thyroid gland, a procedure known as a thyroidectomy. The study was done in a medical center in southwestern Saudi Arabia by looking back at the medical records of patients who had this surgery between December 2013 and December 2019.

Out of 339 patients, 91.7% had benign (non-cancerous) thyroid disorders and 8.3% had malignant (cancerous) ones. Different types of thyroidectomies were performed including total, hemi, subtotal, and near-total thyroidectomies. Some patients, about 36.9%, were treated without surgery.

Of all the patients studied, 11.3% had complications after the surgery. These complications include nerve damage affecting the voice box, temporary low calcium levels, paralysis of a nerve in the throat, and bleeding in the surgical wound.

The study concludes that the rate of complications after thyroid surgery is still high and that more measures need to be taken to lower these rates. The study, however, had some limitations. It only looked back at past records and didn’t follow up with patients to see if they had any long-term complications after their surgery. There was no conflict of interest in this study.

FAQs

  1. What is a thyroidectomy and why is it performed?
  2. What are the major postoperative complications of thyroidectomy?
  3. What was the overall complication rate found in the study conducted in southwestern Saudi Arabia?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to closely follow postoperative instructions, including taking prescribed medications as directed, attending follow-up appointments, and monitoring for any signs of complications such as difficulty breathing, hoarseness, or numbness in the fingers and toes. It is important to communicate any concerns or symptoms to your healthcare provider promptly to ensure proper management and prevent potential complications.

Suitable For

Patients who are typically recommended thyroidectomy include those with:

  1. Benign thyroid disorders such as goiter, thyroid nodules, and Graves’ disease.
  2. Malignant thyroid disorders such as thyroid cancer.
  3. Patients with hyperthyroidism who do not respond to medical treatment.
  4. Patients with thyroid nodules that are suspicious for cancer.
  5. Patients with recurrent thyroid nodules after previous thyroid surgery.
  6. Patients with large thyroid nodules causing symptoms such as difficulty swallowing or breathing.

Timeline

Before thyroidectomy:

  • Patient presents with symptoms such as difficulty swallowing, hoarseness, enlarged thyroid gland, or abnormal thyroid function tests
  • Patient undergoes preoperative evaluation including blood tests, imaging studies, and possibly a fine needle aspiration biopsy
  • Surgery is scheduled and patient may need to prepare by fasting before the procedure

After thyroidectomy:

  • Patient is monitored closely in the recovery room for any immediate complications such as bleeding, difficulty breathing, or changes in voice
  • Patient may stay in the hospital for 1-2 days for observation and management of pain and swelling
  • Patient is prescribed thyroid hormone replacement therapy if the entire gland is removed
  • Patient may experience temporary hoarseness, difficulty swallowing, or low calcium levels (hypocalcemia) as common postoperative complications
  • Patient is followed up with regular visits to monitor thyroid function, calcium levels, and to check for any long-term complications such as recurrent laryngeal nerve injury or hypothyroidism.

What to Ask Your Doctor

Some questions a patient should ask their doctor about thyroidectomy include:

  1. What are the potential risks and complications associated with thyroidectomy?
  2. How experienced are you in performing thyroidectomy procedures?
  3. What is the success rate of thyroidectomy in treating my specific thyroid condition?
  4. Will I need to take any medications after the surgery, such as thyroid hormone replacement?
  5. How long is the recovery period after thyroidectomy, and what can I expect during that time?
  6. Are there any dietary or lifestyle changes I should make before or after the surgery?
  7. How will my voice be affected by the surgery, and what can I do to protect my vocal cords?
  8. Will I need any follow-up appointments or tests after the surgery?
  9. What are the signs of complications that I should watch out for after the surgery?
  10. Are there any alternative treatments to thyroidectomy that I should consider?

Reference

Authors: Bawa D, Alghamdi A, Albishi H, Al-Tufail N, Sharma SP, Khalifa YM, Khan S, Alhajmohammed MA. Journal: Ann Saudi Med. 2021 Nov-Dec;41(6):369-375. doi: 10.5144/0256-4947.2021.369. Epub 2021 Dec 2. PMID: 34873936