Central Lymph Node Dissection Increases the Rate of Postoperative Complications During Thyroidectomy Surgery - a Retrospective Observational Study

Abstract Introduction Total thyroidectomy is a commonly performed endocrine surgical procedure. Where thyroid malignancy is suspected, additional central lymph node dissection (CLND) may be performed intraoperatively leading to greater tissue dissection. The aim of this study was to assess the impact of CLND during thyroidectomy surgery on postoperative outcomes. Method This single center retrospective observational study was performed with reference to STROBE guidelines. Data from 712 patients undergoing total thyroidectomy and total thyroidectomy with CLND was collected during a 1-year period between September 2021 and September 2022. Patients were assessed by demographic data, surgical characteristics and complication rates including hypocalcemia, dysphonia and length of hospital stay. Results 567 of the patients underwent total thyroidectomy and 145 patients underwent a total thyroidectomy with central lymphadenectomy. There was no statistically significant difference in age (55 vs. 58, p = 0.768) or sex (88% vs. 86% female, p = 0.914) between the groups. Overall, there was a 14% rate of complications in thyroidectomy with CLND group and 8% rate in thyroidectomy group (p = 0.022). 4% and 7% rates of hypocalcaemia (p = 0.140), 3% and 8% rates of dysphonia (p = 0.016) were recorded in thyroidectomy with CLND and thyroidectomy alone groups, respectively. There was no significant difference in oesophageal damage or post operative bleeding rates between the groups. Conclusions Thyroidectomy with CLND compared to thyroidectomy alone is associated with increased rates of post operative complications. These findings are most likely associated with greater tissue dissection and tissue manipulation.