Does Thyroidectomy in this Era Confer Risk of Mortality?

Thyroidectomy nowadays is a safe procedure with most centers advocating same day discharge. However even in best centers mortality is still an enigma especially in patients undergoing surgery for Locally advanced thyroid cancer [1]. “Mortality after thyroid surgery, insignificant or still an issue?” [2]. This article addressed the issue of occurrence and types of complications in this era of technocrat surgeons, those who are equipped with various surgical gadgets in their armamentarium, with the effort to reduce both the morbidity and mortality of surgical procedures. History of thyroid surgery has made us remember about contributions of various surgeons and importance of their keen observations, analysis and inferences that has changed the profile of thyroid surgery from one of high mortality to safe day care surgery [3,4].

The mortality declined drastically due to availability of specialized surgical care [5], improved precise knowledge about thyroid and parathyroid anatomy and delicate well described surgical techniques supplemented by vessel sealing devices. The incidence of mortality among patients with tracheal invasion and significance of extent of tracheal invasion in causing morbidity and mortality including difficult airway management even for experienced anaesthelogist and also the probable need to do pre-operative tracheostomy even in this era. The experience of the operating surgeon and his team and also the anesthetist in handling airway issues and hemorrhage from a vascular goiter can be a challenging task and the best policy for a knife happy thyroid surgeon is to choose and plan well, so that procedure goes well, and the patient finally gets well..

1. Wang LY, Nixon IJ, Patel SG, Palmer FL, Tuttle RM, et al. (2016) Operative management of locally advanced, differentiated thyroid cancer. Surgery 160(3): 738-746.
2. Gómez RJ, Sitges SA, Moreno LP, Zambudio AR, Ortega SJ, et al. (2015) Mortality after thyroid surgery, insignificant or still an issue? Langenbecks Arch Surg 400(4): 517-522.
3. Perera AH, Patel SD, Law NW (2014) Thyroid surgery as a 23-hour stay procedure. Ann R Coll Surg Engl 96(4): 284-288.
4. Seybt MW, Terris DJ (2010) Outpatient thyroidectomy: Experience in over 200 patients. Laryngoscope 120(5): 959-963.
5. Beahrs OH, Ryan RF, White RA (1956) Complications of thyroid surgery. J Clin Endocrinol Metab 16(11): 1456-1469.