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Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients

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Abstract

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.

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Acknowledgment

The study was supported by grants from the European Union (Interreg. III A), the Swedish National Board for Health and Welfare and the Swedish Association of Local Authorities and Regions.

Author information

Authors and Affiliations

  1. Director for the Scandanavian Quality Register for Thyroid and Parathyroid Surgery, Lund, Sweden

    A. Bergenfelz

  2. Department of Surgery, Lund University Hospital, 221 85, Lund, Sweden

    A. Bergenfelz

  3. Department of Surgery, Sahlgrenska Hospital, Gothenburg, Sweden

    S. Jansson

  4. Department of Surgery, Umeå University Hospital, Umeå, Sweden

    A. Kristoffersson

  5. Department of Surgery, Helsingborg Central Hospital, Helsingborg, Sweden

    H. Mårtensson

  6. Department of Surgery, Karolinska University Hospital, Stockholm, Sweden

    E. Reihnér & G. Wallin

  7. Department of Breast and Endocrine Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

    I. Lausen

Authors
  1. A. Bergenfelz
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  2. S. Jansson
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  3. A. Kristoffersson
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  4. H. Mårtensson
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  5. E. Reihnér
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  6. G. Wallin
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  7. I. Lausen
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Corresponding author

Correspondence to A. Bergenfelz.

Additional information

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.

Best of Endocrine Surgery in Europe 2008.

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Bergenfelz, A., Jansson, S., Kristoffersson, A. et al. Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbecks Arch Surg 393, 667–673 (2008). https://doi.org/10.1007/s00423-008-0366-7

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  • DOI: https://doi.org/10.1007/s00423-008-0366-7

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