Can thyroidectomy be considered safe in obese patients? A retrospective cohort study

BMC Surgery

Gian Luigi Canu¹  Fabio Medas¹  Enrico Erdas¹  Pietro Giorgio Calò¹  Federico Cappellacci¹  Michele Guido Podda¹  Giorgio Romano² 

[1] Department of Surgical Sciences, University of Cagliari, “Policlinico Universitario Duilio Casula”, 09042, Monserrato, CA, Italy;Department of Surgical, Oncological and Oral Sciences, Section of General and Urgent Surgery, University of Palermo, 90127, Palermo, Italy;

关键词: Thyroidectomy;    Endocrine surgery;    Obesity;    Body mass index;    BMI;    Complications;   

DOI  :  10.1186/s12893-020-00939-w

来源: Springer

【 摘 要 】

BackgroundObesity is a growing public health concern in most western countries. More and more patients with high body mass index (BMI) are undergoing surgical procedures of all kinds and, in this context, obese patients are undergoing thyroid surgery more than ever before.The aim of the present study was to evaluate whether thyroidectomy can be considered safe in obese patients.MethodsPatients undergoing thyroidectomy in our Unit between January 2014 and December 2018 were retrospectively analysed.Patients were divided into two groups: those with BMI < 30 kg/m2 were included in Group A, while those with BMI ≥ 30 kg/m2 in Group B. Univariate analysis was performed to compare these two groups.Moreover, multivariate analyses were performed to evaluate whether the BMI value (considered in this case as a continuous variable) had a significant role in the development of each individual postoperative complication.ResultsA total of 813 patients were included in this study: 31 (3.81%) were underweight, 361 (44.40%) normal-weight, 286 (35.18%) overweight, 94 (11.57%) obese and 41 (5.04%) morbidly obese. Six hundred and seventy-eight patients were included in Group A and 135 in Group B.At univariate analysis, the comparison between the two groups, in terms of operative time and thyroid weight resulted in statistically significant results (P = 0.001, P = 0.008; respectively). These features were significantly higher in Group B than in Group A. About postoperative stay and complications, no statistically significant difference was found between the two groups.At multivariate analyses, only the development of cervical haematoma was statistically significantly correlated to the BMI value. Patients with high BMI had a lower risk of cervical haematoma (P = 0.045, OR 0.797, 95% CI 0.638–0.995).ConclusionsThis study showed that obesity, in the field of thyroid surgery, is not associated with any increase of postoperative complications. Thus, it is possible to conclude that thyroidectomy can be performed safely in obese patients. Our result about operative times had no clinical significance.

【 授权许可】

CC BY