Comparing Thyroidectomy Techniques: Assessing Outcomes

The predictor variable was surgical technique, i.e., TT with versus without pCNLD, which were recorded as a binary parameter. In the TT-alone group, the patients were totally thyroidectomized due to the incidental finding of the cancer after the final pathological report with the patient’s willingness (consent). The main outcome variables included: (1) complications, that is, recurrent laryngeal nerve (RLN) palsy, temporary and permanent hypoparathyroidism, postoperative bleeding, injury to adjacent organ (esophagus, trachea, etc.); (2) recurrence parameters. The vocal cord status was assessed by routine pre- and postoperative indirect laryngoscopy and ultrasound. Temporary vocal cord palsy was defined as decreased or absent vocal cord mobility that resolved within 6 months after surgery. Permanent vocal cord palsy was defined as vocal cord dysfunction persisting more than 6 months after the initial surgery. To determine hypoparathyroidism, serum calcium levels were investigated preoperatively and on each postoperative day. Parathyroid hormone (PTH) levels were tested daily (normal level: 12–88 pg/mL). Symptomatic hypocalcemia was diagnosed if the calcium level was <2.17 mmol/L and patients complained of any symptoms (such as perioral and digital paresthesia, tetany, and palpitation), irrespective of the duration of hospital stay. Routine calcium supplementation was given to all patients. Permanent hypocalcemia or hypoparathyroidism was defined as an ongoing need for calcium or vitamin D supplementation >12 months.
The other study parameters were (1) demographic (age and gender) and (2) tumor-related (tumor staging, TNM status, and histopathological results). Age was recorded as a continuous parameter, gender was categorized into binary, and the tumor status was assessed as nominal scales.