AUDIT OF POST-THYROIDECTOMY COMPLICATIONS AT HOSPITAL TELUK INTAN

Abstract

INTRODUCTION
Thyroidectomy is a common surgical procedure performed for various thyroid conditions. While generally safe, evaluating post-thyroidectomy complications is crucial for improving patient outcomes. This study audits the incidence and types of complications following thyroidectomy at Hospital Teluk Intan.

METHODOLOGY
This retrospective audit analyzed medical records of patients who underwent thyroidectomy at Hospital Teluk Intan from January to December 2024. Data collected included patient demographics, surgical types, and complications within one year after surgery. Complications assessed were hypocalcemia, hemorrhage, vocal cord palsy, wound infection, and other rare events.

RESULT
A total of 33 thyroidectomy procedures were performed in 2024, comprising 21 total thyroidectomies and 12 hemithyroidectomies. The majority of patients were female (29 cases, 88%), with a mean age of 47 years. The leading indication for surgery was suspicious nodules on fine-needle aspiration cytology (FNAC) (23 cases, 70%), followed by multinodular goiter (6 cases, 18%) and compressive symptoms (4 cases, 12%).

Histopathological analysis identified papillary carcinoma as the most common malignancy (12 cases, 36%), followed by follicular carcinoma (5 cases, 15%), secondary thyroid metastasis (1 case, 3%), and Hürthle cell carcinoma (1 case, 3%). Among benign cases, 12 were nodular hyperplasia (36%) and 2 were benign adenomas (6%).

Post-thyroidectomy complications occurred in 51% of cases, predominantly after total thyroidectomy. Hypocalcemia due to hypoparathyroidism was the most frequent complication (13 cases, 39%), with a strong correlation to thyroid mass size (9 cases). Vocal cord palsy occurred in 4 cases, with 2 involving larger thyroid mass. No cases of significant postoperative bleeding or infection requiring reoperation were reported. A Chi-square test revealed a significant association between the type of surgery, with total thyroidectomy being more frequently associated with postoperative hypocalcemia.

CONCLUSION
This audit highlights that post-thyroidectomy complications remain a significant concern, particularly following total thyroidectomy, with hypocalcemia being the most common adverse outcome. The findings underscore the importance of thorough preoperative assessment, surgical precision, and vigilant postoperative monitoring—especially for patients with larger thyroid masses or those undergoing total thyroidectomy.