Complications after the surgical treatment of malignant thyroid disease.
OBJECTIVE
Our objectives were to document the complication rates after total thyroidectomy or lobectomy for malignant thyroid disease and to compare these rates with previously documented complication rates after operations for benign thyroid disease.


METHODS
This is a retrospective chart review of patients diagnosed with thyroid carcinoma at a tertiary military medical center from 1996 to 2000.


RESULTS
Eighty-two patients were identified with thyroid carcinoma, of which 81 underwent surgical treatment. Nine patients had complications related to their treatment, four were permanent. This included two cases of permanent postoperative hypoparathyroidism, one case of phrenic nerve injury, and one case of unilateral vocal cord paralysis. There is a statistically significant higher overall complication rate of this series (10%) in comparison to a similar series of patients surgically treated for benign thyroid disease (2%) when comparing only recurrent laryngeal nerve injury and hypoparathyroidism (p = 0.02). There is also a higher overall complication rate (11% vs. 4.9%); however, this does not reach statistical significance (p = 0.16).


CONCLUSIONS
Recurrent laryngeal nerve injury and hypoparathyroidism complication rates after operations for malignant thyroid disease are statistically higher in this series than complication rates after operations for benign thyroid disease. Overall complication rates are also higher for malignant thyroid disease as compared to benign thyroid disease. Before surgical treatment for malignant thyroid disease, patients should be counseled accordingly.
Spear
Samuel A
SA
Division of Otolaryngology, Madigan Army Medical Center, ATTN: MCHJ-SET, Tacoma, WA 98431-5000, USA.
Theler
Jared
J
Sorensen
Douglas M
DM
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007011:Hypoparathyroidism / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D061226:Recurrent Laryngeal Nerve Injuries; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D016896:Treatment Outcome; D014481:United States