Indications and Complications of Total Thyroidectomy in the Management of Thyroid Diseases: A Five-Year Retrospective Study in a Greek Population

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OBJECTIVE: This retrospective study aimed to record, analyze, and evaluate data concerning patients who underwent total thyroidectomy, focusing on the main indications that led to surgical therapy, as well as postoperative complications and oncological outcomes. MATERIALS AND METHODS: A retrospective study was conducted on 312 patients who underwent total thyroidectomy or lobectomy at the First Department of Surgery of Sismanogleio General Hospital in Athens between 2019 and 2024. Demographic data, indications, intraoperative parameters, complications, and histological findings were recorded. Statistical analyses were performed using SPSS v29.0. RESULTS: Among the 312 patients, 222 (71.2%) were female, and 90 (28.8%) were male, with a mean age of 54.3±13.3 years. Total thyroidectomy was performed in 96.5% of the cases. The main indications were nodular hyperplasia (31.4%), autoimmune thyroiditis (18.9%), multinodular goiter (12.8%), and papillary carcinoma (17.3%). The overall complication rate was 31.7%, with transient postoperative hypocalcemia being the most common complication (25.3%). Permanent hypocalcemia occurred in 1.9% of patients, hemorrhage in 3.5%, and recurrent laryngeal nerve palsy in 1.3% of patients. Papillary carcinoma was the most frequent malignancy, followed by follicular, medullary, and anaplastic carcinomas. Approximately 20% of patients were diagnosed with incidental carcinoma-mostly papillary microcarcinoma-emphasizing the importance of total thyroidectomy, even for benign thyroid diseases. CONCLUSIONS: Total thyroidectomy is a safe and effective therapeutic option with low rates of permanent complications. The systematic identification and preservation of the parathyroid glands, intraoperative nerve monitoring, and meticulous hemostasis are key factors for minimizing inadvertent complications and optimizing outcomes.

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