Tracheostomy In The Surgery Of The Thyroid Gland

Background. Thyroid surgery is connected with postoperative respiratory obstruction which may necessitate tracheostomy.Objectives. The aim of the study was to assess the indications, course, and outcomes of patients who underwent thyroidectomy requiring tracheostomy at Wroclaw University 1(st) Department and Clinic of General, Gastroenterological, and Endocrinologic Surgery between 1996 and 2008.Material and Methods. The clinical data of patients who underwent thyroidectomy with tracheostomy were retrospectively analyzed based on their hospital records.Results. Of the 4971 patients operated on for various diseases of the thyroid, tracheostomy was necessary in 13 (0.26%). The decision to perform tracheostomy was taken intra-operatively because of locally advanced thyroid cancer in 7 (54%) patients (4 patients with anaplastic cancer, 2 with follicular cancer, and 1 with medullar cancer). There were 5 patients requiring tracheostomy because of bilateral injury of the recurrent nerves; 2 had a secondary thyroid operation and 3 had hyperthyroid goiter. Tracheostomy was necessary for one patient who had postoperative hematoma and dyspnea.Conclusions. There are many preoperative factors for the development of serious respiratory complications, such as a secondary procedure on the thyroid, thyroid cancer, huge goiter, retrosternal extension, tracheal deformity with narrowing, or preoperative recurrent laryngeal nerve palsy (Adv Clin Exp Med 2009, 18, 4, 385-388).