A new study published in the The Journal of Clinical Endocrinology and Metabolism suggests that complications from thyroid surgery are more common than previously believed.
Investigators used the Surveillance, Epidemiology and End Results (SEER) database to look at 22,867 patients who had undergone surgery for thyroid cancer between 1998 and 2011. They reviewed general postoperative complications, such as fever, infection, blood clots, or swelling, and complications specific to thyroid surgery, such as hypoparathyroidism, hypocalcemia, and vocal cord or fold paralysis.
Overall, the researchers found that 6.5% of these patients reported general postoperative complications in the month following surgery, and 12% experienced complications specific to the surgery within the year following the procedure. “That 12% of patients overall had thyroid surgery-specific complications is concerning. Most of our surgeons quote a 1% to 3% rate. This is quadruple what we had thought,” said lead study author Maria Papaleontiou, MD, an assistant professor of metabolism, endocrinology, and diabetes in the department of internal medicine at Michigan Medicine in Ann Arbor.
They also found that the risks were significantly higher for certain groups. Older patients were approximately three times more likely to experience complications than those younger than 65. Ten percent of older patients developed general postoperative complications and 19% reported thyroid surgery-related complications. For patients younger than age 65, 3% had general complications and 6% had thyroid surgery-related complications.
Advanced disease was associated with the highest number of complications: 23% of patients whose cancer had spread had thyroid surgery-specific complications, a number the researchers called “alarming.”
The researchers suggested better educating patients and providers so that those at risk of complications seek out high-volume surgeons, who tend to have better outcomes. Other studies have shown that low-volume surgeons perform a disproportionate number of thyroid surgeries in the United States.