Clinical Outcomes of Total Thyroidectomy: A Three-Year Experience at a High-Specialty Referral Center

Abstract

Background:
Total thyroidectomy is the standard surgical treatment for a wide spectrum of thyroid gland diseases. However, minimizing specific postoperative complications remains a priority in endocrine surgery.
Objectives: To evaluate the frequency and nature of postoperative complications, as well as the clinical outcomes of total thyroidectomy over a three-year period at a specialized center.
Materials and methods: A retrospective analysis was conducted on the surgical treatment of 425 patients who underwent total thyroidectomy. Indications for surgery were multinodular goiter (n = 248), differentiated thyroid cancer (n = 142), and Graves' disease (n = 35). In all cases, precise dissection and intraoperative neuromonitoring of the laryngeal nerves were applied.
Results: Transient hypoparathyroidism developed in 58 (13.6%) patients postoperatively, while persistent hypoparathyroidism was recorded in 6 (1.4%) patients. Temporary recurrent laryngeal nerve dysfunction was noted in 11 (2.6%) patients, and persistent paresis in 2 (0.5%). Postoperative bleeding requiring wound revision occurred in 3 (0.7%) patients. The average postoperative hospital stay was 2.4 ± 0.8 days. In malignant neoplasms, radical intervention (R0) was achieved in 98.6% of patients.
Conclusions: Total thyroidectomy performed at a specialized center with intraoperative neuromonitoring is characterized by a low rate of persistent complications and high clinical efficacy.

Keywords:
Total Thyroidectomy; Thyroid Gland; Hypoparathyroidism; Recurrent Laryngeal Nerve; Postoperative Complications