Combined Laparoscopic Bariatric Surgery and Thyroidectomy: A Proof-of-Concept Study

Background: Thyroid diseases are common in bariatric surgery candidates, and some of these thyroid diseases require surgical treatment. Combined bariatric surgery and thyroidectomy have not been reported yet. This study aimed to evaluate the efficacy and safety of this combined surgery.Methods: A retrospective study was conducted on all patients undergoing combined laparoscopic bariatric surgery and thyroidectomy between March 2015 and April 2021. Perioperative and follow-up outcomes were collected and analyzed.Results: Combined surgery was successfully conducted in 14 patients, with a mean body mass index of 35.7 +/- 5.6 kg/m(2). Two patients underwent Roux-en-Y gastric bypass, 12 underwent sleeve gastrectomy, and all received unilateral or bilateral thyroid surgery with/without central lymph node dissection. The average operative time was 259.3 +/- 54.8 (170-318) minutes. Two patients encountered postoperative transient hypocalcemia, and one experienced transient recurrent laryngeal nerve (RLN) paralysis. No reoperation, mortalities, or readmission was identified. The median duration of follow-up is 27 months; all patients had no hypocalcemia or RLN paralysis at the last follow-up.Conclusion: Combined laparoscopic bariatric surgery and thyroidectomy are effective and safe for elected patients. Strict operation indications, rich experience in laparoscopic surgery, and appropriate postoperative management are keys to the success of combined surgery.