One-Day Thyroid Surgery – Is it Safe?

• Authors: Maria Wieloch , Piotr Koza , Krzysztof Kuzdak , Piotr Ziemniak , Krzysztof Kołomecki
• Languages of publication: EN

Abstracts

EN

was to evaluate the safety of one-day thyroid surgery based on the assessment of the incidence of early postoperative complications.Material and methods. The study comprised 726 patients who underwent total thyroidectomy during the period between January, 2012 and February, 2013. The study considered the three most common thyroidectomy complications.Results. In the group of 726 patients, recurrent laryngeal nerve paralysis was observed in 22 cases, accounting for 3.07% of all patients. Postoperative bleeding was observed in 12 cases (1.65%). In 8 cases, bleeding occurred during the first 8 hours after surgery, while in the remaining four cases- 9, 12, 18, and 26 hours after surgery. The study group was divided into three subgroups, in which the concentrations of calcium and parathyroid hormone, 6 hours and 20 hours after surgery, were determined. In the first group (223 patients), only the parathyroid hormone level was determined. The decreased PTH level was associated with the appearance of tetany symptoms in 15% of cases. Amongst patients in whom the parathyroid hormone level was normal, tetany symptoms were observed in 0.5% of cases. In the second group (256 patients), only the serum calcium level was determined. Amongst patients with normal serum calcium levels, 1% of cases presented with tetany symptoms. In patients where the serum calcium level was reduced, tetany symptoms appeared in 35% of cases. In the third group (247 patients), both serum calcium and parathyroid hormone levels were determined. In the group of patients with normal, both serum calcium and parathyroid hormone levels, tetany symptoms were not observed. Amongst patients with normal serum calcium levels and decreased PTH levels on the day of surgery, tetany symptoms were observed in 25% of cases, while during the first postoperative day-37% of cases.Conclusion. One-day thyroid surgery, due to the appearance of complications cannot be regarded as a completely safe procedure.

Keywords

EN

thyroidectomy; one-day surgery; postoperative bleeding; tetany

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 6
• Pages: 317-322

Dates

published

1 - 06 - 2013

online

05 - 07 - 2013

Contributors

author

Maria Wieloch

• Department of General and Oncological Surgery, Hospital in Kutno, 99-300 Kutno, ul. Kościuszki 52, Kierownik: dr n. med. P. Ziemniak

author

Piotr Koza

• Department of Endocrine and General Surgery, Medical University in Łódź, Kierownik: prof. dr hab. K. Kuzdak

author

Krzysztof Kuzdak

• Department of Endocrine and General Surgery, Medical University in Łódź, Kierownik: prof. dr hab. K. Kuzdak

author

Piotr Ziemniak

• Department of General and Oncological Surgery, Hospital in Kutno, Kierownik: dr n. med. P. Ziemniak

author

Krzysztof Kołomecki

• Department of Endocrine and General Surgery, Medical University in Łódź, Kierownik: prof. dr hab. K. Kuzdak

References

• 1. Grodski S, Serpell J: Evidence for the role of perioperative PTH measurement after total thyroidectomy as a predictor of hypocalcemia. World JSurg 2008; 32(7): 1367-73.[Crossref][WoS]
• 2. Díez Alonso M, Sánchez López JD , Sánchez-SecoPeña MI et al.: Serum PTH levels as a predictive factor of hypocalcaemia after total thyroidectomy. Cir Esp 2009; 85(2): 96-102.[Crossref]
• 3. Doran HE, England J, Palazzo F: Questionable safety of thyroid surgery with same day discharge. Ann R Coll Surg Engl 2012; 94(8): 543-47.[WoS]
• 4. Konturek A, Barczyński M, Stopa M et al.: Total thyroidectomy for non-toxic multinodular goiter with versus without the use of harmonic FOCUS dissecting shears - a prospective randomized study. Wideochir Inne Tech Mało Inwazyjne 2012; 7(4): 268-74.[WoS]
• 5. Materazzi G, Dionigi G, Berti P et al.: One-day thyroid surgery: retrospective analysis of safety and patient satisfaction on a consecutive series of 1,571 cases over a three-year period. Eur Surg Res 2007; 39(3): 182-88.[WoS]
• 6. Mirnezami R, Sahai A, Symes A et al.: Day-case and short-stay surgery: the future for thyroidectomy? Int J Clin Pract 2007; 61(7): 1216-22.[WoS][Crossref][PubMed]
• 7. Quiros RM, Pesce CE, Wilhelm SM et al.: Intraoperative parathyroid hormone levels in thyroid surgery are predictive of postoperative hypoparathyroidism and need for vitamin D supplementation. Am J Surg 2005 Mar; 189(3): 306-09.
• 8. Costanzo M, Marziani A, Condorelli F et al.: Post-thyroidectomy hypocalcemic syndrome: predictive value of early PTH. Preliminary results. Ann Ital Chir 2010 Jul-; 81(4): 301-05.[PubMed]
• 9. Grodski S, Serpell J: Evidence for the role of perioperative PTH measurement after total thyroidectomy as a predictor of hypocalcemia. World JSurg 2008 Jul; 32(7): 1367-73.[Crossref][WoS]
• 10. Lombardi CP, Raffaelli M, Princi P et al.: Parathyroid hormone levels 4 hours after surgery do not accurately predict post-thyroidectomy hypocalcemia. Surgery 2006; 140(6): 1016-23.[WoS]
• 11. Proczko-Markuszewksa M, Kobiela J, StefaniakT i wsp.: Pooperacyjny pomiar PTH jako wczesny czynnik rokowniczy hipokalcemii po operacjach całkowitego wycięcia gruczołu tarczowego. PolPrzegl Chir 2010; 82: 40-48.
• 12. Promberger R, Ott J, Kober F et al.: Normal parathyroid hormone levels do not exclude permanent hypoparathyroidism after thyroidectomy. Thyroid 2011; 21(2): 145-50.[PubMed][WoS][Crossref]
• 13. Jumaily JS, Noordzij JP, Dukas AG et al.: Prediction of hypocalcemia after using 1- to 6-hour postoperative parathyroid hormone and calcium levels: an analysis of pooled individual patient data from 3 observational studies. Head Neck 2010; 32(4): 427-34.[WoS]

Identifiers

DOI

10.2478/pjs-2013-0047