The relation between preoperative ultrasonographic thyroid volume analysis and thyroidectomy complications.

ABSTRACT

OBJECTIVE: To determine the relation between thyroid volume (ThV) and thyroidectomy complications using preoperative ultrasound and ellipsoid volumetric analysis in Turkish patients. PATIENTS AND METHODS: This prospective study included a total of 500 patients (401 females = 80.2% and 99 males = 19.8%) who were operated for benign goiter. According to their ThV estimated by ultrasound hey were classified in three groups 1. less than 50 ml (n = 269; 53.8%), 2. between 50 and 100 ml (n = 151; 30.2%), 3. more than 100 ml (n = 80; 15.6%). By comparing the association of thyroid volume with peroperative and postoperative complications it was evaluated whether the thyroid volume could be an effective factor participating in morbidity and mortality of patients. RESULTS: Total peroperative complication rate was 2% (n = 10) with trachea injury in 2 (0.4%), bleeding in 8 (1.6%) patients. Peroperative complications were significantly more frequent in patients with large volume (p = 0.003). Temporary hypocalcemia rate in patients with less than 50 ml volume was highly significant (p < 0.001). Volume average was low in patients with hypocalcemia as compared to patients without hypocalcemia (p < 0.001). Both the temporary and permanent vocal cord paralysis (VCP) were significantly more frequent in patients with larger volumes (p = 0.002). All four patients with permanent VCP had more than 100 ml volume. CONCLUSION: Thyroid volume is an important factor affecting thyroidectomy complications. In patients with smaller ThV increased risk of hypocalcemia was found, whereas in those with larger ThV increased risk of recurrent nerve damage and peroperative bleeding was observed.