Total Thyroidectomy versus Hemithyroidectomy: A Comparative Study of Complications and Surgical Outcomes

Introduction: Thyroidectomy is a commonly performed surgical procedure for the management of benign and malignant thyroid disorders. The two principal approaches, total thyroidectomy and hemithyroidectomy, differ in extent of resection and are associated with varying complication profiles. Understanding these differences is essential for optimal surgical decision-making. The study aimed to compare the complication rates between total thyroidectomy and hemithyroidectomy and to evaluate associated operative and postoperative outcomes. Materials and Methods: This hospital-based comparative observational study was conducted in the Department of ENT and Head and Neck Surgery at Deccan College of Medical Sciences, Hyderabad, from January 2025 to December 2025. A total of 50 patients undergoing thyroid surgery were included and divided into two groups: total thyroidectomy (n=25) and hemithyroidectomy (n=25). Demographic and clinical variables were recorded. Postoperative complications including hypocalcaemia, recurrent laryngeal nerve injury, haemorrhage, and wound infection were assessed. Statistical analysis was performed using SPSS version 26.0, with p<0.05 considered significant. Results: The overall complication rate was significantly higher in the total thyroidectomy group (44.0%) compared to the hemithyroidectomy group (20.0%) (p=0.04). Transient hypocalcaemia was significantly more frequent following total thyroidectomy (32.0% vs. 4.0%, p=0.01). No significant differences were observed in permanent hypocalcaemia, recurrent laryngeal nerve injury, hemorrhage, or wound infection. The mean duration of surgery and hospital stay were significantly higher in the total thyroidectomy group (p<0.001). Conclusion: Total thyroidectomy is associated with a higher complication rate, particularly hypocalcaemia, along with increased operative time and hospital stay compared to hemithyroidectomy. Careful patient selection and surgical planning are essential to balance treatment efficacy and safety.