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Prevalence of major structures injury in thyroid and neck surgeries: a national perspective
Journal article   Open access

Prevalence of major structures injury in thyroid and neck surgeries: a national perspective

Zaid Al-Qurayshi, Christopher Blake Sullivan, Nitin Pagedar, Gregory Randolph and Emad Kandil
Gland surgery, Vol.9(6), pp.1924-1932
12/01/2020
DOI: 10.21037/gs-20-369
PMCID: PMC7804541
PMID: 33447543
url
https://doi.org/10.21037/gs-20-369View
Published (Version of record) Open Access

Abstract

Background: The objectives of the study is to examine the prevalence and burden of major structures injury (pharynx, esophagus, trachea, larynx, lymphatic, vessels & nerves) in patients who underwent thyroid, parathyroid, and neck dissection surgeries in the United States. Methods: The study is a retrospective cross-sectional analysis utilizing the Nationwide Readmissions Database, 2010-2015. The study population included adults (18 years) patients who underwent thyroid, parathyroid, and neck dissection surgeries. Results: A total of 54,443 patients were included. Major structures injury was reported in 221 (0.48%) patients. The injured structures were vascular (0.22%), lymphatic (0.18%), pharynx/esophagus (0.06%), neural (0.03%), and trachea/larynx (0.002%). The risk of injury increased annually during the study period (OR: 1.29, 95% CI: 1.16, 1.44, P<0.001). The risk of injury was highest in patients who underwent thyroidectomy with neck dissection (1.01%) or neck dissection alone (1.81%) (P<0.001 each). The risk was also highest for patients with a head and neck cancer diagnosis (OR: 1.80, 95% CI: 1.24, 2.61, P=0.002). Patients with those injuries had a higher prevalence of blood transfusion (2.82% vs. 0.17%), postoperative fistula (3.10% vs. 0.03%), readmission (28.90% vs. 3.59%), and postoperative mortality (0.87% vs. 0.06%) (P<0.05 each). Management of patients with those injuries was associated with a longer hospital stay by 4.86 +/- 0.48 days (P<0.001), and a higher cost by $16,151.00 +/- 173.36 (P<0.001). Conclusions: Injuries of major structures in thyroid and neck surgeries are more prevalent in cancer patients. There has been a recent increase in the risk of such injuries in the United States. Those injuries are associated with significant clinical and economic burden.
 Life Sciences & Biomedicine Science & Technology Surgery

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