Prospective Study of Complications Following Surgery for Thyroid Malignancy: A Tertiary Cancer Care Centre Experience XC01-XC04
Dr. Nebu Abraham George,
Level IV, Department of Surgical Oncology, Regional Cancer Centre, Medical College Campus, Thiruvananthapuram, Kerala, India.
Introduction: Surgery is the backbone for treatment of thyroid malignancy. Total thyroidectomy with or without neck dissection is standard of care. Thereafter adjuvant treatment, usually radioiodine, depends upon risk stratification of the patient. Common complications of total thyroidectomy are hypocalcaemia and voice change.
Aim: To find out incidence and risk factors for hypocalcaemia and voice change after surgery for carcinoma thyroid.
Materials and Methods: The present study was a prospective observational study. It included all patients who had undergone total thyroidectomy with or without neck dissection for carcinoma thyroid within a period of October 2010 to June 2011. Fifty patients were included in the final analysis. Complications, mainly hypocalcaemia, voice change, following surgery were studied.
Results: The present study included a total of 50 patients, 34 were female and 16 male. Hypocalcaemia was seen in 24 patients. Twenty one had temporary and three had permanent hypocalcaemia. Central compartment neck dissection was found to be significantly associated with hypocalcaemia. Six week, after surgery 14 patients complained of perceptual voice dysfunction, of these 11 had complained of fatigue. At the end of one year, only one patient had voice dysfunction.
Conclusion: Most of the complications following thyroidectomy are temporary; usually patients recover well from hypocalcaemia and voice changes. Incidence and severity are said to be more with malignant thyroid compared to thyroidectomy for benign aetiology. Most studies in literature regarding complications of the thyroidectomy include both benign and malignant cases. The present study includes all patients with proven or suspicious of malignancy, in an attempt to have, a homogenous group with regard to aetiology.