title: Complications in primary and completed thyroidectomy.
abstract: OBJECTIVE
  To compare the rates of postsurgical complications following a primary and completed thyroidectomy for multinodular goiter (MNG).
  
  
  METHODS
  A total of 7123 cases of thyroidectomy in two hospitals from 1990 to 2007 (n = 3834 [53.83%] total [TT], n = 2238 [31.42%] subtotal [ST], and n = 1051 [14.75%] hemithyroidectomy [HT]) were studied for complications. The follow-up checked for injury of the laryngeal nerves, hypoparathyroidism, pathology recurrence, and appearance of neoplasm.
  
  
  RESULTS
  Postoperative mean follow-up: 7 years 9 months Primary operation: permanent recurrent laryngeal nerve (RLN) injury was observed in 1.4% in the TT group, 1.2% in the ST, and 0.9% in the HT group (P > 0.1 vs ST and TT). Permanent hypocalcaemia: 3.5% in TT group, 2.5% in the ST, in 1.4% in the HT. Eight hundred and seventy-seven patients suffered recurrence of MNG (n = 482 after ST, n = 395 after HT). Five hundred and sixty-four recurrent cases required a completion thyroidectomy. Reoperations: Permanent RLN injury was observed in 3% in the post-ST group and 2.5% in the post-HT group. Permanent hypocalcemia: 5.9% in the post-ST group and 4% in the post-HT group.
  
  
  CONCLUSIONS
  There is no significant difference in complications between a primary TT and ST. The rates of complications after a completed thyroidectomy are significantly higher in comparison with the primary operations. High rates of reoperation in cases of recurrent pathology and incidental carcinoma were reported.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Assaf HaRofeh Medical Center-Sackler Faculty of Medicine, Tel Aviv University, Zerifin, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.forename: Andrey
authors.initials: A
authors.lastname: Nagibin
authors.forename: Julian
authors.initials: J
authors.lastname: Olevson
mesh_terms: D005260:Female; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D007011:Hypoparathyroidism / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D061226:Recurrent Laryngeal Nerve Injuries; D012086:Reoperation; D013964:Thyroid Neoplasms; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome