ROLE OF PRE - OPERATIVE INVESTIGATIONS IN PREVENTING THE POST - OPERATIVE COMPLICATIONS OF THYROID SURGERY

Background: Thyroidectomy is a surgical procedure indicated as elective treatment for symptomatic thyroid swellings or neoplasms. Today most of the complications of thyroid surgery are related to either metabolic derangements or injury to the recurrent laryngeal nerve injury. Other complications include superior laryngeal nerve injury, infection, airway compromise, and bleeding. Hence, before any thyroid surgery patient must be precisely informed the possible complications and their remedies. The present study aims to evaluate post-operative complications after thyroid surgery.Methods: In a tertiary care hospital based longitudinal study patients presenting with clinically and sonographically diagnosed thyroid swelling who underwent surgical intervention were enrolled in the study. These patients were evaluated for thyroid profile test, fine needle aspiration cytology (FNAC), pre-operative and post-operative indirect laryngoscopy, serum calcium level and histopathology. Intra operative and post-operative assessment was done for bleeding, hematoma, and surgical site infection.Results: A total of 53 patients were enrolled. Thyroid swelling was more common in females (F: M =5.6:1) mostly presenting in 3rd and 4th decades with mean age of 38.1 years. Hemithyroidectomy was the most common procedure performed (63.6%) followed by total (27.3%) and near total thyroidectomies (5.5%). On histopathological examination most common finding was nodular goiter (49.1%) followed by multinodular goiter (28.3%), follicular adenoma (16.9%) and malignancies (5.7%). The post-operative complications after thyroidectomies were hypocalcemia (16.9%), recurrent laryngeal nerve (RLN) injury (5.7%), and surgical site infection (1.9%).Conclusions: Careful evaluation of post thyroidectomy complications will help in reducing these complications and patient’s safety.

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A STUDY OF POST-OPERATIVE COMPLICATIONS OF THYROID SURGERY

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2017/92 ◽

2017 ◽

Vol 6 (05) ◽

pp. 413-418

Author(s):

Anbalagan P ◽

Manikannan S ◽

Mohammed Imran Khan A

Keyword(s):

Thyroid Surgery ◽

Operative Complications ◽

Post Operative Complications

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Early post-operative complications of thyroid surgery- A study of 50 cases in a tertiary level hospital of Bangladesh

Scientific Research Journal ◽

10.31364/scirj/v7.i6.2019.p0619664 ◽

2019 ◽

Vol VII (VI) ◽

Author(s):

Md Shazibur Rashid ◽

Mohammad Al Mamun Hamid ◽

Md Jahangir Alam Majumder ◽

Md Rafiqul Islam Sarkar ◽

Ratan Kumar Das Chawdhury ◽

...

Keyword(s):

Thyroid Surgery ◽

Tertiary Level ◽

Operative Complications ◽

Level Hospital ◽

Post Operative Complications

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PS02.180: THE ROLE OF CARDIOPULMONARY EXERCISE TESTING IN OESOPHAGO-GASTRIC CANCER SURGERY: EVALUATION OF A SINGLE-CENTRE EXPERIENCE

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.180 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 173-173

Author(s):

Sophie Allen ◽

Saurav Chakravartty ◽

David Timbrell ◽

Timothy Rockall ◽

Pradeep Prabhu ◽

...

Keyword(s):

High Risk ◽

Exercise Testing ◽

Conflicts Of Interest ◽

Cardiopulmonary Exercise Testing ◽

Low Risk ◽

Test Results ◽

Cardiopulmonary Exercise ◽

Operative Complications ◽

Post Operative Complications

Abstract Background Cardiopulmonary exercise testing (CPEX) is an objective measure of functional capacity adapted to predict post-operative morbidity. CPEX may also identify optimisable cardio-respiratory comorbidity, prompting treatment modification or specialist referral. The role of CPEX in patient optimisation before oesophago-gastrectomy is yet to be evaluated. This study aims to assess the utility of CPEX in altering management and optimising patients prior to oesophago-gastrectomy. Methods All patients who underwent pre-operative CPEX testing and two phase oesophago-gastrectomy (January 2012 to January 2018) were included. All changes in patient management brought about by CPEX findings were evaluated. In addition, the role of validated risk-stratifying CPEX parameters (anaerobic threshold (AT), VO2 peak and FEV1) in predicting post-operative complications was assessed. Results 236 patients underwent surgery. Median AT and VO2 peak were 11.95(7–24)ml/kg/min and 773(403–1552)ml/min/m2 respectively. 46% (109/236) of patients (VO2 peak > 800ml/min/m2) were graded ‘low risk’, 42% (99/236) ‘intermediate risk’ (VO2 peak = 600–800ml/min/m2), and 12% (28/236) ‘high risk’ (VO2 peak < 600ml/min/m2) for developing post-operative cardio-pulmonary complications. Based on CPEX findings, management plans were altered in 84 patients (36%). Cardiac comorbidity was identified in 55 patients (23%) with immediate alteration of cardiac medications in 9% (21/236) and another 11% (27/236) requiring specialist cardiology review. Medication for respiratory optimisation was initiated in 3% (7/236) and formal respiratory review sought in 5% (12/236). ‘Intermediate’ and ‘high risk’ patients had similar rates of overall complication (63% vs 63%, P = 1.00), cardio-pulmonary complication (48% vs 47%, P = 0.17), anastomotic leak (11% vs 15%, P = 0.33) and 90-day mortality (6% vs 4%, P = 0.40) compared with ‘low risk’ groups. CPEX variables (AT, VO2 peak, FEV1) did not predict complications, length of critical care or overall stay on Receiver Operating Characteristic curves (AUROC < 0.5) and multivariate logistic regression models. Conclusion CPEX findings changed management in 36% of patients, enabling optimisation before oesophago-gastrectomy. ‘Confounding by intention’ is a bias reducing the strength of association between test results and post-operative complications due to the propensity to medically intervene on the basis of the test findings. This study highlights the possibility that the high intervention rate may explain the poor correlation between test results and post-operative outcome. Disclosure All authors have declared no conflicts of interest.

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