Factors influencing thyroidectomy complications.

UNLABELLED: The postoperative outcome of thyroidectomies is related to factors concerning the patient, the thyroid disease, and the surgeon. OBJECTIVES: To analyze a clinic's experience with thyroidectomy complications. STUDY DESIGN: historical cross-sectional cohort study. MATERIALS AND METHODS: We reviewed the charts from 228 patients submitted to thyroidectomy, between 1991 and 2004. Transient, permanent and total complications as well as persistence and recurrence of the basal disease were studied in relation to clinical and laboratory factors. RESULTS: Total complications occurred in 34.65%, transient complications in 18.86% (9.21% had hypocalcemia, 0.44% had vocal cord paralysis), associated with the first postoperative years and pressure complaints, and permanent complications in 17.98% (8.77%: hypoparathyroidism; 1.75%: vocal cord paralysis), associated with malignancy and more radical surgeries. The thyroid disease persisted in 17.98% of the cases, associated with age and recurrence in 10.96%, associated with the first operative years, benign diseases and less radical surgeries. CONCLUSION: The complications were associated with pressure complaints, shorter complaining period, malignancy and more radical surgeries. The recurrence was associated with the first operative years, non-neoplastic thyroid diseases and less radical surgeries. The persistence of disease was associated with older age.

Does radioiodine therapy in patients with differentiated thyroid cancer increase the frequency of another malignant neoplasm?

Objectives. To compare the frequency of another primary malignancy in patients with differentiated thyroid carcinoma (DTC) who received radioiodine therapy or not ((131)I). Material and Methods. 168 cases of DTC patients were retrospectively evaluated as to the frequency of another neoplasia by comparing patients with and without it, taking into account clinical, laboratory, and therapeutic parameters. Results. Another primary malignancy occurred in 8.9% of patients. Of these, 53.3% showed the malignancy before (131)I and 46.7% after it. By comparing both groups, the age at the moment of diagnosis of another neoplasia was 46.1 ± 20.2 years for the group before (131)I therapy and of 69.4 ± 11.4 years for the group after it (P = 0.02). Of the 148 patients treated with (131)I, 4.7% developed another malignancy. The latter were older (61 ± 17 years) than those who did not show another cancer type (44.1 ± 14.2 years) (P < 0.05). Conclusion. The frequency of another neoplasia found after (131)I was similar to that found before (131)I.

Fatores que influenciam nas complicações das tireoidectomias / Factors influencing thyroidectomy complications

O resultado pós-operatório das tireoidectomias é imputado a fatores relativos ao paciente, à tireopatia e ao cirurgião. OBJETIVO: Analisar a experiência de um serviço quanto a complicações com a tireoidectomia. Desenho do estudo: coorte histórica com corte transversal. MATERIAL E MÉTODO: Foram avaliados os prontuários de 228 pacientes submetidos à tireoidectomia, entre 1991 e 2004. Foram estudadas as complicações transitórias, definitivas e totais, persistência e recidiva da tireopatia de base, em relação a fatores clínico-laboratoriais. RESULTADOS: Ocorreram 34,65% de complicações totais, 18,86% de complicações transitórias (9,21% hipocalcemia, 0,44% paralisia de cordas vocais, 4,82% outras), associadas aos primeiros anos de cirurgia no serviço e queixas compressivas, e 17,98% de complicações definitivas (8,77% hipoparatireoidismo, 1,75% paralisia de cordas vocais, 0,44% rouquidão), associadas à malignidade e cirurgias mais radicais. Houve persistência da doença de base em 17,98% dos casos, associada à idade, e recidiva em 10,96%, associada aos primeiros anos de cirurgia, benignidade e cirurgias menos radicais. CONCLUSÃO: Complicações pós-operatórias se associaram a queixas compressivas, história curta, malignidade e cirurgias mais radicais. A recidiva se associou aos primeiros anos de cirurgia no serviço, tireopatias benignas e cirurgias menos radicais. A persistência da doença se associou à maior idade.

The postoperative outcome of thyroidectomies is related to factors concerning the patient, the thyroid disease, and the surgeon. OBJECTIVES: To analyze a clinic's experience with thyroidectomy complications. Study design: historical cross-sectional cohort study. MATERIALS AND METHODS: We reviewed the charts from 228 patients submitted to thyroidectomy, between 1991 and 2004. Transient, permanent and total complications as well as persistence and recurrence of the basal disease were studied in relation to clinical and laboratory factors. RESULTS: Total complications occurred in 34.65%, transient complications in 18.86% (9.21% had hypocalcemia, 0.44% had vocal cord paralysis), associated with the first postoperative years and pressure complaints, and permanent complications in 17.98% (8.77%: hypoparathyroidism; 1.75%: vocal cord paralysis), associated with malignancy and more radical surgeries. The thyroid disease persisted in 17.98% of the cases, associated with age and recurrence in 10.96%, associated with the first operative years, benign diseases and less radical surgeries. CONCLUSION: The complications were associated with pressure complaints, shorter complaining period, malignancy and more radical surgeries. The recurrence was associated with the first operative years, non-neoplastic thyroid diseases and less radical surgeries. The persistence of disease was associated with older age.