A Comparison Between Complications Following Total Versus Subtotal Thyroidectomy: A Literature Review

Abstract

Thyroidectomy is a common procedure performed for various medical conditions such as hyperthyroidism, thyroid nodules, and thyroid cancer. As with any other procedure, thyroidectomy has several complications such as Recurrent Laryngeal Nerve (RLN) injury, hypocalcemia, and hematoma. Total thyroidectomy and subtotal thyroidectomy are two main types of procedures performed with each having their own common complications. This literature review aims to compare common complications that occur in total thyroidectomy and subtotal thyroidectomy. Three main complications, RLN injury, hypocalcemia, and hematoma formation, are reviewed using PubMed/MEDLINE and Google Scholar with a Synthesis Without Meta-analysis (SWiM) approach to ensure a clear and reliable reporting of findings. Complications post thyroidectomy may be life threatening where prompt attention and follow up is needed to insure effective management. Risk factors for hematoma formation include age >45, gender (male sex), Graves’ disease, systolic blood pressure >150, and the use of Ketorolac or Aspirin. Identification of the RLN intra-operatively is an important step in order to decrease the risk of occurrence. While hypocalcemia is the most common post-operative complication, an increased risk of developing both hypocalcemia and hypoparathyroidism occurs in total thyroidectomy in comparison to subtotal thyroidectomy. In conclusion, complications from thyroidectomy may be life threatening indicating the necessity of post-operative care. The incidence and measures for decreasing the risk of post-operative complications may vary with the type of thyroidectomy performed.