Prospective evaluation of factors affecting post thyroidectomy outcome at three teaching hospitals from october1,2019-april30,2020,in Addis Ababa, Ethiopia.
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Date
2019-10
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Addis Abeba University
Abstract
Background: Postoperative complications after thyroidectomy are problematic for patients and
surgeons. The postoperative outcome of thyroidectomies is related to risk factors concerning the
patient, the thyroid disease and the surgeon. Thyroidectomy complications may be divided into
transient or permanent. The transient may vary from severe, life threatening ones, all the way to
mild and meaningless events. Permanent complications, which prevalence is variable, represent the
main concern of those who treat thyroid diseases surgically. Despite its importance, the risk factors
associated with post-thyroidectomy complications are not enough analyzed.
Objectives: To evaluate factor affecting post thyroidectomy outcome in three teaching Hospitals in
Addis Ababa Ethiopia.
Method: A prospective study was conducted in surgical department of Black Lion, Yekatit and
Zewuditu Memorial Hospital. The study has included patients diagnosed for thyroid swelling and
operated from October 1 2019 –April 30, 2020, meeting the following criteria: MNG; operation by
surgeons with various experiences; and minimum follow-up of 1 month. Age, thyroid function test,
indication for surgery, types of surgery, surgeon experience, intraoperative adhesion and estimated
blood loss were analyzed as risk factors for post thyroidectomy outcome.
Data was analyzed using SPSS version 20.0. P values < 0.05 were considered statistically
Significant.
Result: During the study period 120 thyroidectomies were performed. There were 20 (16.66%)males and 100 females (83.33%)with Male to female ratio was 1:5.Total Thyroidectomy+,LND
performed in 4(3.3%) and Total thyroidectomy alone was performed in 10(8.3.%) patients. Total
complications occurred was 23 (19.16%) in 120 patients. Wound infection was the most
complication seen in 7(5.8%)of patients and hematoma was seen in 6(5%)patients. 3(2.5%)of
patients suffered from recurrent laryngeal nerve palsy and hypocalcemia.
There was association b/n early postoperative complication with
age (p value=.025
b
), Indication for Surgery (p value.031
b,
)and type of surgery (p value.045
).
Estimated Blood Loss was significantly associated with hematoma (p value.000
b
b
). Early
postoperative complication also has significantly associated with thyroid function test (p
value.005
b
), adhesion (p value.035b) and operating surgeon (p value .022b).
no association b/n early postoperative complication with, size and duration of goiter
There was no postoperative mortality in this study.
Conclusion
The factors affecting post thyroidectomy outcome were indication for surgery, estimated blood loss,
type of surgery, thyroid function test, adhesion and surgeon experience.
Patient with these factors should be advised for possible higher rate of complications and the
surgeon should be prepared beforehand.
Recommendation:
Patients with thyroid malignancy, with considerable intraoperative bleeding needs careful
hemostasis, can rebleed and develope hematoma.
Further study is necessary to identify the cause of wound site infection as commonest complication
observed was sugical site infection.
Description
Keywords
Thyroidectomy,Postoperative complications ,patients ,surgeons.