[Multivariate study of risk factors for developing complications after multinodular goiter surgery].
BACKGROUND
Multinodular goiter (MG) accounts for a large volume of procedures performed in endocrine surgery departments. However, risk factors for postoperative complications have not been systematically investigated. The aim of the present study was to evaluate surgical outcomes in terms of morbidity and mortality through multivariate statistical analysis with a view to determining risk factors in MG surgery.


METHODS
A total of 672 patients who underwent surgery for MG were retrospectively reviewed. The variables analyzed were age, sex, prior surgery, disease duration, symptomatology, intrathoracic component, the surgeons experience, surgical technique, identification of structures, associated thyroid carcinoma and thyroid specimen weight. The chi-squared test, Students t-test and logistic regression analysis were performed.


RESULTS
Morbidity was 22% (n = 147) and mostly corresponded to hypoparathyroidisms and transitory recurrent lesions. Risk factors for developing these complications were symptomatic disease (p = 0.0131), hyperthyroidism (p = 0.0333), compressive symptoms (p = 0.0158), clinical grade of the goiter (p = 0.0482), surgical technique (p < 0.00001) and thyroid weight (p = 0.0302). Independent risk factors were surgical technique, hyperthyroidism and goiter grade. The definitive complication rate was 2.2% (n = 15), corresponding to six hypoparathyroidisms (0.9%) and 10 recurrent lesions (1.5%). The risk factor for their development was hyperthyroidism (p = 0.0037; RR = 2.8).


CONCLUSIONS
The main independent risk factor for complications after MG surgery is hyperthyroidism.
Ríos
Antonio
A
Servicio de Cirugía General y del Aparato Digestivo I, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia. ARZRIOS@teleline.es
Rodríguez
José Manuel
JM
Canteras
Manuel
M
Riquelme
Juan
J
Illana
Julián
J
Balsalobre
María Dolores
MD
Parrilla
Pascual
P
D005260:Female; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors