One of the complications that can appear during thyroid surgery is hemorrhage due to bleeding, either from the thyroid tissue itself or from the thyroid arteries that must be sectioned. On the other hand, in cases of aggressive tumor disease that require greater complexity due to the need to intervene in other areas of the neck, lesions of major vessels, trachea, esophagus or thoracic duct may appear, or even the opening of the pleura or cervical nerve lesion; all of them may occur very infrequently and can generally be solved during the same surgical act.
However, complications usually arise during the postoperative period. The most frequent complications are: wound infection or hemorrhage, altered phonation, loss of function of a vocal cord, decreased blood calcium levels or decreased activity of the parathyroid glands, which are close to the thyroid.
These complications may require local treatment or antibiotics if there is infection, or emergency reoperation if there is bleeding that compromises the airway. Vocal cord paralysis usually resolves spontaneously after a few weeks, although it may require the support of a phoniatrician. In relation to the decrease in blood calcium levels, this can be supplemented with calcium and vitamin D tablets, for as long as necessary until normalization of the activity of the parathyroid glands, usually a few weeks.
Permanent complications of thyroid surgery
Sometimes the activity of the nerve that moves the vocal cord does not recover and the patient is left with a paralyzed cord. This can have different clinical consequences on speech, of greater or lesser importance, which can be alleviated with a small intervention on the area and with phoniatric education.
Very exceptionally, permanent involvement of both vocal cords may occur, requiring an urgent tracheostomy to be performed in order to be able to breathe.
Mortality rates in thyroid surgery
Mortality in thyroid surgery is very low. In our experience 0% after more than 2,000 operations. In any case, it is generally dependent on other associated diseases of the patient, especially cardiopulmonary.
Latest advances in thyroid surgery
The main variable of success in this surgery is the surgeon’s experience. Recently, tools have emerged to help both in the form of modern anesthesia equipment and new anti-bleeding technologies, such as ultrasonic or bipolar electrothermal dissection, or help in locating recurrent nerves. On the other hand, endoscopic techniques are still far from matching the traditional technique.