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Factors associated with thyroidectomy complications in resource-limited settings: An observational study

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ABSTRACT Background: Even though thyroidectomy outcomes and their predictive factors are various and widely studied, the data from our country and other African countries where the disease burden is high are limited. The main aim of this study was to evaluate the incidence and factors associated with thyroidectomies complication in a resource limited setting where the procedures were performed by general surgeons/general surgery residents. Methods: This is an observational study of one hundred ninety-nine patients undergoing elective thyroidectomy from September 1, 2020, to August 30, 2021. The primary outcomes are the incidence and types of complications observed during and after surgery. The secondary outcomes are identifying risk factors associated with complications. Bivariate and multivariate logistic regressions were used to identify risk factors. P-value < 0.05 was considered statistically significant. Result: The incidence of complications after thyroid surgeries was 18.6%. The two commonest complications were an external branch of the superior laryngeal nerve (EBSLNI) injury and hypocalcemia. Thyroidectomy performed by residents and patients who underwent total thyroidectomy, the independent risk factor of the EBSLN injury [AOR = 8.015; 95%CI (1.402–45.807); P = 0.019 and postoperative hypocalcemia [AOR = 17.797; 95%CI (3.799–83.374); P < 0.001, resulted in an incidence of 7.54% and 5.53% respectively. Conclusion: The incidence of thyroidectomy complications is relatively similar to other studies. However, the provision of special training for residents on surgical techniques to prevent EBSLN injury and performing non-total thyroidectomies for benign thyroid diseases are recommended to reduce complications. Highlights
Title: Factors associated with thyroidectomy complications in resource-limited settings: An observational study
Description:
ABSTRACT Background: Even though thyroidectomy outcomes and their predictive factors are various and widely studied, the data from our country and other African countries where the disease burden is high are limited.
The main aim of this study was to evaluate the incidence and factors associated with thyroidectomies complication in a resource limited setting where the procedures were performed by general surgeons/general surgery residents.
Methods: This is an observational study of one hundred ninety-nine patients undergoing elective thyroidectomy from September 1, 2020, to August 30, 2021.
The primary outcomes are the incidence and types of complications observed during and after surgery.
The secondary outcomes are identifying risk factors associated with complications.
Bivariate and multivariate logistic regressions were used to identify risk factors.
P-value < 0.
05 was considered statistically significant.
Result: The incidence of complications after thyroid surgeries was 18.
6%.
The two commonest complications were an external branch of the superior laryngeal nerve (EBSLNI) injury and hypocalcemia.
Thyroidectomy performed by residents and patients who underwent total thyroidectomy, the independent risk factor of the EBSLN injury [AOR = 8.
015; 95%CI (1.
402–45.
807); P = 0.
019 and postoperative hypocalcemia [AOR = 17.
797; 95%CI (3.
799–83.
374); P < 0.
001, resulted in an incidence of 7.
54% and 5.
53% respectively.
Conclusion: The incidence of thyroidectomy complications is relatively similar to other studies.
However, the provision of special training for residents on surgical techniques to prevent EBSLN injury and performing non-total thyroidectomies for benign thyroid diseases are recommended to reduce complications.
Highlights.

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