January - March 2019, Volume 15, Issue 1

Giulea C, Enciu O, Toma EA, Martin S, Fica S, Miron A

Total Thyroidectomy for Malignancy - is Central Neck Dissection a Risk Factor for Recurrent Nerve Injury and Postoperative Hypocalcemia? A Tertiary Center Experience in Romania

Acta Endo (Buc) 2019, 15 (1): 80-85
doi: 10.4183/aeb.2019.80

Introduction. Surgery for thyroid cancer carries a higher risk of morbidity given the region’s complicated anatomy, the setting of malignancy and extent of the surgery. Aim. To investigate the rate of complications related to the recurrent nerve and parathyroid glands lesions in patients with thyroid carcinoma that undergo thyroid surgery and lymph node dissection. Patients and Methods. The data of 71 patients who underwent total thyroidectomy and 19 patients who underwent total thyroidectomy and central neck dissection with various associated neck dissection techniques were investigated using appropriate statistical tests. Results. As expected, the rate of recurrent nerve injury observed in the neck dissection group was higher than in the total thyroidectomy group (15.7% vs. 2.8%, p=0.05). As for postoperative hypocalcemia, the rate observed in the neck dissection group, both for postoperative day 1 (p<0.0001) and day 30 (p=0.0003) was higher than in the total thyroidectomy group (68.4% vs. 19.7% postoperative day 1, 31.5% vs. 4.2% postoperative day 30). Conclusions. The risk of morbidity concerning the recurrent nerve injury and postoperative hypoparathyroidism increases with the extent of surgery. Extensive surgery may achieve proper oncologic outcomes but increases the risk of postoperative morbidity and decreases quality of life. In deciding for extensive surgery, both patient and medical team need to understand these risks.

Keywords: thyroid cancer, thyroid surgery, recurrent nerve injury, postoperative hypocalcemia.

Correspondence: Octavian Enciu MD, “Carol Davila” University of Medicine and Pharmacy, Dept. of Surgery, Str. Dionisie Lupu 37 Bucharest, 030167, Romania, E-mail: esoctavian@gmail.com