LOCAL COMPLICATIONS AFTER SURGICAL RESECTION FOR THYROID-CARCINOMA

BACKGROUND: One of the issues in the debate surrounding the extent of thyroid excision for localized, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection . This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer. MATERIALS AND METHODS: Ninety-o ne patients with thyroid carcinoma were identified from tumor registri es at a university, veterans administration, and private hospital over a 36-year period. Forty-five patients (49%) underwent total thyroidec tomy, 28 (31%) subtotal thyroidectomy, and 18 (20%) thyroid lobectomy. RESULTS: Permanent postoperative local complications occurred in 4% o f patients. Forty-four patients (48%) experienced temporary local comp lications: transient hypocalcemia in 38 (42%), airway obstruction in 3 (3%), postoperative bleeding iu 2 (2%), and recurrent laryngeal nerve injury in 1 (1%). The local complication rate increased in direct rel ationship to the extent of thyroid resection. There were no postoperat ive deaths. CONCLUSION: The most frequent underreported morbidity afte r thyroid resection is transient hypocalcemia. Compared to other life- threatening or permanent postoperative complications that could occur, transient hypocalcemia is relatively less important, and the signific ance of its identification is predominantly economic.