Complications of Thyroidectomy in Hashimoto Thyroiditis vis-à-vis Benign Goitres

Abstract

Introduction Surgery for Hashimoto thyroiditis (HT) can be difficult due to dense inflammatory process surrounding the gland and postoperatively patient can develop hypocalcaemia, recurrent laryngeal nerve injury, haematoma and infection. Purpose of this study was to compare the rate of post-operative complications in HT with that in benign goitres. Materials and Methods Data of the patients, who underwent thyroidectomy for benign goitres between January 2013 and December 2017, were reviewed retrospectively. Patients were divided in to two groups. Group A included patients confirmed to have Hashimoto thyroiditis (n=148) and Group B included patients who underwent thyroidectomy for other benign thyroid disorders (n=430). Results A total of 578 patients who underwent thyroidectomy for benign thyroid diseases were included in the present retrospective study. Group A consisted of 148 patients who had HT. Group B consisted of 430 patients who had other benign thyroid diseases. The data was analysed using SPSS 23 and p-value < 0.05 was considered as statistically significant. Patients undergoing thyroidectomy in HT had significantly higher post-operative complication rate (p<0.005). Of the 148 patients with HT, 31.6% (77) had hypocalcaemia while 68.4% (167) with benign goitres had hypocalcaemia. In addition, 51.8% of the patients in the HT group were later diagnosed with malignancy; there were no malignancies present in the group B. Conclusion Though patients with HT suffer higher rate of complications after thyroidectomy when compared to benign goitres, careful pre-operative planning and risk counselling of patients with improved surgical techniques helps to minimize postoperative morbidity.

Keywords

• Hashimoto Thyroiditis
• Goitre, Benign
• Hemithyroidectomy
• Hypocalcaemia