Munawar Jamil, Mughees Amin, Muhammad Amin.
Risk factors for respiratory complications in Thyroidectomy.
J Surg Pak Jan ;7(4):12-6.

Respiratory obstruction is a serious complication of Thyroidectomy, which may require urgent intervention in order to restore airway and save life. This is an observational study to find out the frequency of risk factors and causes of obstructive respiratory complications. The study was conducted in the surgical unit-I Bahawal Victoria Hospital Bahawalpur from August 1999 to December 2001. One hundred patients of goiter were included in the study. Data of each patient was collected on a Proforma and analyzed, on SPSS for X2 (Chi Square), to access an association between respiratory complications and the risk factors. The p value of less than .05 was considered statistically significant. The presence or absence of predictive factors for the development of serious postoperative respiratory obstruction were recorded. These factors were Goiter for more than 5 years, Large goiter, Preoperative recurrent laryngeal nerve palsy, Postoperative recurrent laryngeal nerve palsy, Tracheal deviation and narrowing, Retrosternal extension and Thyroid Cancer, Progressive Stridor Difficult intubations and tracheomalacia. Complication were managed on the basis of clinical judgment and not influenced by the presence of any of these factors. Postoperative respiratory complications occurred in 27 patients and were obstructive in 19 patients and non obstructive in 8 patients. Removal of stitches and Re-exploration in emergency operation theater was done in 8 tracheostomy in 7 and re-intubation in 4 patients. There was no death. At least four or more of the recorded risk factors were present in 13 of 19 patients who developed respiratory obstruction compared with the 81 patients who did not. Identification of multiple risk factors in patients undergoing thyroid surgery is useful for anticipating of respiratory complications. It is also useful for better and prompt management of respiratory complications.

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