Long-term outcomes after total thyroidectomy

INTRODUCTION: The aim of this study was to assess the complication rates of total thyroidectomy in a regional hospital setting in Denmark for permanent hypoparathyroidism, recurrent laryngeal nerve palsy and post-operative bleeding. Furthermore, the long-term outcomes in the management of hypoparathyroidism were investigated. METHODS: This was a retrospective study of 114 consecutive patients undergoing total thyroidectomy due to benign thyroid disease. RESULTS: A total of 0.9% suffered from permanent recurrent laryngeal nerve palsy, whereas temporary nerve palsy was seen in 1.8%. Post-operative bleeding occurred in 5.4%. The frequencies of temporary and permanent post-operative hypocalcaemia were 22.8% and 17.4%, respectively. Autotransplantation of parathyroid tissue was performed in 23.7%. Unintentional parathyroidectomy occurred in 8.7%. Serum ionized calcium was significantly lower preoperatively in the group that developed hypocalcaemia (p = 0.03). CONCLUSIONS: The incidence of recurrent laryngeal nerve palsy was similar to that reported in other published studies. Post-operative bleeding was more common than in other studies. The high frequency of permanent post-operative hypocalcaemia is a cause for concern. We need to consider implementing a guideline to facilitate outfacing calcium and vitamin D supplements as an attempt to phase out was not attempted in all patients. FUNDING: not relevant. TRIAL REGISTRATION: The study was approved by the Danish Data Protection Agency, but has not been registered due to its register-based design.