Concurrent endocrine and other surgical procedures: an institutional experience

• Published in: The Journal of surgical research Vol. 211; pp. 107 - 113
• Main Authors: Morris, Rachel, MD, Yen, Tina W.F., MD, MS, Doffek, Kara, BS, Carr, Azadeh A., MD, Wilson, Stuart D., MD, Evans, Douglas B., MD, Wang, Tracy S., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2017
• Subjects: Adrenalectomy; Adult; Aged; Aged, 80 and over; Concurrent procedures; Databases, Factual; Endocrine Surgical Procedures; Feasibility Studies; Female; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Outcome Assessment (Health Care); Parathyroidectomy; Patient Readmission - statistics & numerical data; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Risk Factors; Surgery; Surgical outcomes; Thyroidectomy; Adrenalectomy; Surgical outcomes; Concurrent procedures; Parathyroidectomy; Thyroidectomy
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2016.12.013

Abstract Inroduction The number of endocrine procedures, specifically parathyroidectomy, thyroidectomy, and adrenalectomy, being performed is increasing. There is a paucity of literature on the feasibility of combining these procedures with other surgical procedures. Therefore, the aim of this study was to determine the effect of performing concurrent surgical procedures on postoperative outcomes. Methods This is a single institution retrospective review of multiple prospectively maintained databases of patients who underwent elective thyroidectomy, parathyroidectomy, and/or adrenalectomy in combination with another procedure. The other procedures included soft tissue, breast or hernia, abdominal major, abdominal minor, cervical, and “other”. Demographics, operative details, length-of-stay, and 30-d outcomes were reviewed. “Endocrine-specific” complications included recurrent laryngeal nerve injury, hypoparathyroidism, cervical wound infection, hematoma, and other. Results The cohort comprised 104 patients. Overall, 19 (18%) patients had 21 complications, including endocrine-specific complications in eleven (11%) patients. These eleven complications included recurrent laryngeal nerve injury ( n  = 3; 3%), hematoma ( n  = 2; 2%), wound infection ( n  = 1; 1%), transient hypoparathyroidism ( n  = 2; 2%), and other ( n  = 3; 3%). The remaining complications included three (3%) general complications, six (6%) patients with complications related to the concurrent procedure, and one patient who underwent an open adrenalectomy and hysterectomy and developed a midline wound dehiscence, which could not be specifically attributed to either procedure. Conclusions Less than 5% of patients undergoing a surgical endocrine procedure underwent a concurrent procedure, ranging from soft tissue to major abdominal. Short-term endocrine-specific complications were managed safely, suggesting that concurrent procedures can be considered, with minimal effect on patient outcomes.