Complications of surgery for differentiated thyroid cancer

  Complications of DTC surgery include bleeding, incisional infection, respiratory obstruction, parathyroid injury (transient or permanent hypocalcemia), retroglottic nerve injury, superior laryngeal nerve injury, and anesthesia-related complications.  Foreign data show that after total thyroidectomy, the rate of laryngeal nerve injury is 4.3%, the rate of bilateral laryngeal nerve injury is 0.6% (half of the patients underwent tracheotomy), the rate of symptomatic hypocalcemia is 14.0% (permanent hypocalcemia is 2.2%), the rate of postoperative bleeding is 8.0%, and the rate of incisional infection is 0.4%. The incidence of surgical complications was related to the operator’s experience.  To avoid surgical complications as much as possible, it is recommended that: a thorough preoperative surgical risk assessment be done (e.g., how well the respiratory function is, whether there is respiratory infection, whether the vocal cords are normal, whether the trachea is compressed, and whether other underlying diseases are present). If the trachea is compressed and softened, the softened trachea should be suspended from the sternocleidomastoid muscle or anterior cervical muscle group, and in severe cases, tracheotomy should be performed in time; if the parathyroid gland is accidentally removed, the excised parathyroid tissue should be cut into thin slices or granules and planted in the sternocleidomastoid muscle or strap muscle within the operation area after confirmation.