A seven year experience in patients undergoing total thyroidectomy for benign diseases in a single unit of tertiary care centre: a retrospective case study

Authors

  • Dheer S. Kalwaniya Department of General Surgery, Safdarjung Hospital, New Delhi, India
  • Jaspreet S. Bajwa Department of General Surgery, Safdarjung Hospital, New Delhi, India
  • Gowtham K. Gowda Department of General Surgery, Safdarjung Hospital, New Delhi, India
  • Akshay Narayan Department of General Surgery, Safdarjung Hospital, New Delhi, India
  • Rohit Choudhary Department of General Surgery, Safdarjung Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20193697

Keywords:

Goitre, Hypocalcaemia and retrosternal goitre, Recurrent laryngeal nerve injury, Total thyroidectomy

Abstract

Background: Thyroidectomy is a common surgical procedure performed worldwide by surgeons with varied training. It is the experience and the skills by which a surgeon performs, the indication of surgery and the extent of surgery which determines the outcome and the complication rates.

Method: This study is a retrospective study performed from January 2012 to December 2018 when a total of 170 patients underwent total thyroidectomy via kocher’s incision for benign diseases with clinically in hypothyroid state at Safdarjung Hospital, New Delhi in a single unit of a tertiary care hospital.

Results: The male: female ratio was 1:7.09 with average age of patients being 40years. The overall complication rate was 18.82% (32 patients). Postoperative transient hypocalcaemia being the most common complication. There was no case of permanent hypocalcaemia. There was no injury to any nerve (recurrent or superior laryngeal). Transient recurrent laryngeal paresis was noted in 4(2.35%) which resolved with conservative management. Complications like wound infection, sympathetic chain injury were not noted. The characteristic feature of this study was five cases of giant secondary retrosternal goitre which had average weight of greater than 500 grams which were operated using kocher’s incision. The average weight of other 165 patients was 70grams +/- 12 grams. There were no major post-operative complications except for post-operative recurrent laryngeal nerve paresis and seroma formation which was evacuated after 3 weeks of surgery.

Conclusion: Hence, from this it is concluded that it is the surgical experience and skills of the surgeon which make total thyroidectomy a safe procedure providing permanent cure with a low post-operative morbidity risk even with large sized retrosternal thyroid glands which can be operated via neck incision.

References

Ashwini A, Naveen K, Guru A, Badagabettu SN, Shanthakumar SR, Patil J, et al. Safety and effectiveness of total thyroidectomy and its comparison with subtotal thyroidectomy and other thyroid surgeries: a systemic review: J thyroid research: 2016;1-6.

Satyanarayana V, Waddi S. Post thyroid ctomy complications- our experience in tertiary care hospital: J. Evolution Med. Dent. Sci. 2017;6(92):6589-92.

Afolabi A, Ayandipo O. A fifteen year experience of total thyroidectomy for management of simple multinodular goitres in a low medium income country. S African J Surger. 2016;54(4):40-6.

Efremidou E, Papageorgiou M. the efficacy and safety of total thyroidectomy in management of benign thyroid disease: a review of 932 cases: Canadian J surger. 2009;52(1):39-44.

Cirocchi R, Trastulli S, Randolph J, Guarino S, Di Rocco G, Arezzo A, et al. total or near total thyroidectomy vs subtotal thyroidectomy for multinodular nontoxic goitre in adults: cochrane database of systematic reviews. 2015:(8).

Zahir H, Kumaran MP. total thyroidectomy for benign thyroid diseases – our experience: Journal Med Science Clin Research. 2017;5;25519-23.

Pisanu A, Montisci A, Cois A, Uccheddu A. Surgical indications for toxic multinodular goitre. Chirurgia italiana. 2005;57(5):597-606.

Perzik S. The place of total thyroidectomy in management of 909 patients with thyroid disease: Am J surg. 1976;132(4):480-3.

Gough I, Wilkinson D: Total thyroidectomyfor management of thyroid disease: World J Surg. 2000 Aug 1;24(8):962-5.

Tartaglia F, Sgueglia M: complications of total thyroidectomy: our experience and a number of considerations: chirurgia Italiana. 2003;55(4):499- 510.

McHenry C, Piotrowski JJ. Thyroidectomy in patients with marked thyroid enlargement: airway management, morbidity and outcome: Am surgery: 1994;60(8):586-91.

Thomusch O, Machens A. The impact of surgical technique on post-operative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients: surgery: 2003;133(2):180-5.

Pradeep P, Aggarwal A. safety and efficacy of surgical management of hyperthyroidism: 15 year experience from a tertiary care centre in a developing country: World J Surgery. 2007;31(2):306-12.

Downloads

Published

2019-08-27

How to Cite

Kalwaniya, D. S., Bajwa, J. S., Gowda, G. K., Narayan, A., & Choudhary, R. (2019). A seven year experience in patients undergoing total thyroidectomy for benign diseases in a single unit of tertiary care centre: a retrospective case study. International Journal of Research in Medical Sciences, 7(9), 3317–3321. https://doi.org/10.18203/2320-6012.ijrms20193697

Issue

Section

Original Research Articles