Clinical Profile, Surgical Outcomes, and Postoperative Complications Following Total Thyroidectomy: A Prospective Observational Study from a Tertiary Care Centre in Southern India

Abstract

Background: Total thyroidectomy has become an increasingly preferred procedure for a wide range of benign and malignant thyroid disorders, but hypocalcemia, recurrent laryngeal nerve (RLN) injury, and haemorrhage remain important sources of morbidity, and institution-specific prospective data from southern India are limited.

Aims: To evaluate the clinical profile, surgical outcomes, and postoperative complications in patients undergoing total thyroidectomy, and to identify risk factors associated with these complications.

Methods: A prospective observational cohort study was conducted in the Department of General Surgery of a tertiary care hospital in Kuppam, India, over 18 months. Eighty-six consecutive adult patients undergoing total thyroidectomy were enrolled after preoperative thyroid function testing, ultrasonography, and FNAC. Postoperative complications were systematically monitored, and data were analysed in SPSS v23.0 using the chi-square test, independent t-test, and binary logistic regression.

Results: The mean age was 38.41 ± 10.47 years with marked female predominance (83.7%). Colloid goitre (36.1%) and multinodular goitre (30.2%) were the commonest FNAC diagnoses. Mean operative time was 104.41 ± 14.85 minutes and mean blood loss 104.70 ± 21.08 ml. The overall postoperative complication rate was 24.4%, transient hypocalcemia being the commonest complication (10.5%), followed by permanent hypocalcemia (3.5%) and temporary RLN injury (4.7%); no permanent RLN injury, respiratory obstruction, or thyroid storm occurred. Central neck dissection was significantly associated with postoperative hypocalcemia (odds ratio 9.13, 95% CI 1.65–50.59, p = 0.011).

Conclusion: Total thyroidectomy is a safe procedure with an acceptable complication profile in a tertiary care setting. Central neck dissection is an independent risk factor for postoperative hypocalcemia, underscoring the need for meticulous parathyroid preservation and vigilant postoperative monitoring.