title: Prolonged duration of surgery is not a risk factor for postoperative complications in patients undergoing total thyroidectomy: a single center experience in 305 patients.
abstract: BACKGROUND
  Hypocalcemia and nerve injury are the most severe complications after thyroid surgery. The duration of surgery has not been previously considered as a risk factor for postoperative complications in patients undergoing total thyroidectomy. We sort to investigate the influence of prolonged surgery on postoperative complications in patients undergoing total thyroidectomy.
  
  
  METHODS
  We hypothesized that a threshold of > 120 minutes of surgical time could represent a surrogate marker for postoperative complications in patients undergoing total thyroidectomy for benign thyroid disorders. The study population was divided into two groups based on the median duration of surgery (120 min): group I ≤ 120 minutes (control group), group II > 120 minutes (study group). The charts of eligible patients undergoing total thyroidectomy within a six-year period from January 1(st) 2006 to December 31(st) 2012 were reviewed. The primary outcomes included the rates postoperative hypocalcemia and recurrent laryngeal nerve palsy. The secondary outcomes included the rates of postoperative hemorrhage, wound dehiscence and length of hospital stay.
  
  
  RESULTS
  305 cases of thyroidectomy were included for analysis; 130 (42.6%) control group and 175 (57.4%) study group. Transient (15.4% vs 19.4%) and permanent (3.8% vs. 2.9%) hypocalcemia were recorded in control and study group respectively. The incidence of nerve palsy was 1.5% in the control group and 1.4% in the study group. The mean length of postoperative hospital stay was 3d in both groups. There was no significant difference amongst both groups with regard to postoperative bleeding (p = 0.57) and wound dehiscence (p = 0.31). Prolonged surgery (> 120 min) was not identified as a risk factor for increased postoperative complication.
  
  
  CONCLUSIONS
  Prolonged duration of surgery > 120 minutes is not a surrogate marker for postoperative complications in patients undergoing total thyroidectomy.
authors.affiliation: Department of General and Visceral Surgery (A), University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany ; Helios Klinikum Wuppertal, Department of Surgery II, Witten - Herdecke University, Heusner Str. 40, 42283 Wuppertal, Germany.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Ambe
authors.affiliation: Department of General and Visceral Surgery (A), University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Brömling
authors.affiliation: Department of General and Visceral Surgery (A), University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
authors.forename: Wolfram T
authors.initials: WT
authors.lastname: Knoefel
authors.affiliation: Department of General and Visceral Surgery (A), University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Rehders
keywords: Parathormone; Parathyroid glands; Postoperative hypocalcemia; Recurrent laryngeal nerve injury; Thyroid surgery