Revision Thyroid Surgery: Are There More Complications?

Abstract

Objective: To analyze the revision thyroid database of a single thyroid, parathyroid, head and neck surgery institution. To assess whether reoperative thyroid bed surgery is associated with higher postoperative complications.

Method: A retrospective single institutional review over a 5-year period (2004-2009) was performed by the department of thyroid, parathyroid, head and neck surgery, Massachusetts Eye and Ear Hospital, Boston, MA. IRB approval was obtained. All patients who had revision neck or thyroid bed surgery were included.

Results: A total of 117 cases were included in the study with an average age of 46.2 years. The average follow-up time was 2.5 years. The majority of the patients had papillary thyroid cancer (89.8%). The average number of revision surgeries was 1.5 (range 1-7). The average time between primary surgery and the last revision surgery was 7.3 years (0.1-44.1 years). Approximately 14% of patients had preoperative vocal cord palsy and 18% had preoperative permanent hypocalcemia. No patient developed a new temporary or permanent vocal cord palsy. Five patients developed a temporary and 3 a permanent hypocalcemia.

Conclusion: These data indicate that a percentage of patients with papillary thyroid cancer who develop recurrent disease will require further revision thyroid surgery. This has generally been accepted to be a more difficult surgery. These data demonstrate that revision thyroid surgery can be a relatively safe procedure with low complications rates.