REOPERATIONS AND MORBIDITY IN THYROID SURGERY

Objective: Due to adhesions and distorted anatomy resulting from previous operations, reoperations are associated with increased complication rates. This study aims evaluate the morbidity in reoperative thyroid surgery. Material and Method: Medical records of 263 patients were retrospectively rewieved to examine the incidence of complications after reoperative thyroid surgery. Results: Two hundred twenty three of the patients (%84.8) were female and 40 (%15.2) were male. Median age of the patients were 49 (range:13-85). The indication for reoperation was benign pathologies in 156 patients (59.3%) and malignancy in 107 patients (40.7%). Multinodular goiter (n:141, 53.6%) and papillary carcinoma (n:62, 23.6%) were the leading arguments for reoperation. 70% of the patients was referred from another institution. The first operation was subtotal thyroidectomy in 80 (30.4%) patients, nodule excision in 44 (16.7%) patients and near total thyroidectomy in 23 (8.7%) patients. In 116 patients (44%) no information was available about the first operation. 12 patients with tumor (4.6%) were submitted to a radioguided completion thyroidectomy. The mean operation time was 44.6 (30-118) minutes and the mean hospital stay was 1.2 (1-3) day. The complications encountered were transient hypocalcemia in 21 patients (8%), significant hypocalcemia in 5 patients, (2%), and transient vocal cord paralysis in 5 patients (2%). One case (0.4%) had a permanent vocal cord paralysis. No any other complication or mortality was seen. Conclusion: For prevention of recurrence and/or reoperation necessity, the first operation must be sufficient in its extent and patients must be followed and treated adequately.