1.Post-operative bleeding
There are two types of postoperative bleeding. One is bleeding from the thyroid cut surface and incision. This kind of bleeding proceeds slowly, with gradual swelling of the neck, sometimes with bruised skin, and possibly with mild respiratory distress. The sutures should be removed and decompression and drainage should be performed. Second, it is arterial bleeding. It is mostly caused by the dislodgement of the ligature thread of the superior thyroid artery. It often occurs within 1-2 days after surgery due to coughing and exertion. This type of bleeding is rapid, with rapid swelling of the neck, which soon causes respiratory distress or even asphyxia. The incision should be opened immediately, the bleeding point should be found and the bleeding should be stopped.
2. Respiratory distress and asphyxia
In addition to the above-mentioned bleeding and compression causing dyspnea, dyspnea or asphyxia can also be caused by laryngeal edema, tracheal softening and collapse or bilateral laryngeal nerve injury and paralysis.
3.Returning laryngeal nerve injury
Injury to one side of the recurrent laryngeal nerve can cause hoarseness and dysphonia, which is caused by paralysis of the vocal cords on that side. If it is a contusion injury, the paralyzed vocal folds can recover naturally after several months; if it is a ligature or cut injury, the vocal folds are permanently paralyzed. However, the paralyzed vocal folds are gradually straightened in the middle position, and their function can be compensated by the healthy vocal folds, and hoarseness is gradually restored. If both laryngeal nerves are injured, the vocal cords on both sides are tonic in the middle position and cannot be opened, causing asphyxia, requiring tracheotomy and long-term use of tracheal tube.
4.Supraglottic nerve injury
Injury to the external branch of the superior laryngeal nerve can reduce the pitch and coarse pronunciation because it affects the tension of the vocal cords. If the inner branch is injured, it can make the epiglottis mucous membrane lose sensation, appear misopharyngeal, and cause choking and coughing of drinking water. The above symptoms can be gradually reduced due to the compensatory effect of the healthy side.
5.Parathyroid gland injury
Parathyroid gland injury can cause finger twitching, mostly in 2-3 days after surgery, due to the removal of parathyroid glands or insufficient blood supply. The symptoms start with tightness and numbness of the limbs and lips, tingling in the hands and feet, and in severe cases, twitching of the limbs and trunk, several times a day for several minutes each time. Those caused by insufficient blood supply can gradually recover; those who have all cut out apply calcium for life.
6.Thyroid crisis
It is a serious complication of hyperthyroidism after surgery. It usually occurs 24-48 hours after surgery. Its clinical manifestations are persistent high fever, increased pulse rate and elevated blood pressure, which may be accompanied by nausea, vomiting, diarrhea, agitation and restlessness, or even a comatose state. Inadequate preoperative preparation, improper selection of surgical indications; rough intraoperative operation and excessive bleeding; postoperative bleeding, infection and hypoxia are the causative factors.
7. Hematoma formation and infection in the trauma cavity
If the fever does not subside even after 3-4 days after surgery, and if you feel swelling and pain in the neck and see redness and pressure pain in the skin around the incision during examination, you should think about the possibility of hematoma and infection. In the early stage, local hot compresses can be applied to promote the absorption of hematoma. When the hematoma is large, repeated puncture and aspiration can be performed. If an abscess has formed, sutures need to be removed for drainage and antibiotics should be given at the same time.
8.Lymphatic leak or celiac leak.
It is a milky liquid flowing from the drainage tube, sometimes in large amount. The reason is that the lymphatic duct was not ligated or the ligature line was dislodged during the thyroid cancer operation; or the left thoracic duct or the right lymphatic duct was not found or the repair was incomplete. In mild cases, it can be cured by fasting, but in severe cases, a second operation is needed.
9.Low thyroid function
It is caused by the removal of too many glands. It is characterized by weakness, indifference, dry skin, slow movement, and mucous edema of the lower limbs.
The above complications can be completely avoided. Thyroid surgery is a very delicate operation; the operation needs to be done carefully and gently, not roughly and roughly; every action and every step must be well thought out and well planned; especially, the whole process should be dissected, exposed, and the laryngeal recurrent nerve protected to prevent accidental injury; the parathyroid glands should be carefully identified and preserved in situ; sometimes when they are mistakenly cut down or cannot be preserved in situ, they should be found and autologously transplanted in time. In some cases, if the parathyroid gland is incorrectly cut or cannot be preserved in situ, it should be identified and autologously transplanted.
In clinical practice, some surgeons have old complications after surgery, such as injury to the recurrent laryngeal nerve, hypoparathyroidism, intraoperative hemorrhage, postoperative bleeding and reoperation, all of which are related to personal quality and surgical skills! Nowadays, thyroid surgery is a model of development towards specialization and refinement, so choose your hospital and doctor carefully when you visit!