Risk Factors for Postoperative Complications in Patients Reoperated for Persistent/Recurrent Differentiated Thyroid Carcinoma.

INTRODUCTION

This study aimed to identify perioperative risk factors for postoperative complications in patients undergoing reoperation for persistent/recurrent differentiated thyroid carcinoma (DTC).

METHODS

This retrospective study included patients with persistent/recurrent DTC who underwent reoperation at the Head and Neck Surgery Department of our Hospital between June 2021 and December 2023. Postoperative complications assessed were hypoparathyroidism, lymphatic leakage, nerve injury, and postoperative bleeding. Multivariable logistic regression was used to determine factors independently associated with these complications.

RESULTS

A total of 97 patients were included, with a mean age of 46.68 ± 12.82 y, and 38 of them were male. Among these patients, 59 had no postoperative complications, while 38 experienced at least one complication. Multivariable logistic analysis revealed that the number of previous surgeries (odds ratio [OR] = 3.91, 95% confidence interval [CI]: 1.04-14.74, P = 0.044), bilateral lateral cervical lymphadenectomy (OR = 4.69, 95% CI: 1.05-20.99, P = 0.043), thoracic duct ligation (OR = 4.01, 95% CI: 1.22-13.22, P = 0.022), parathyroid hormone levels at admission (OR = 0.58, 95% CI: 0.38-0.89, P = 0.013), and operative time (OR = 1.57, 95% CI: 1.01-2.44, P = 0.045) were significantly associated with postoperative complications.

CONCLUSIONS

This study identified critical perioperative early warning factors for postoperative complications in patients undergoing reoperation for persistent/recurrent DTC. These findings can support healthcare professionals in the early detection, prevention, and management of complications, thereby enhancing patient outcomes and informing more effective perioperative care strategies.