Increased risk of postoperative complications after total thyroidectomy with Graves' disease

Background: The effect of Graves' disease on the risk of postoperative complications in patients undergoing total thyroidectomy is unclear. Methods: The incidence of recurrent laryngeal nerve (RLN) injury and hypoparathyroidism were analyzed between 165 patients with Graves' disease (GD group) and 1:1 matched patients with euthyroid states (control group). Results: The matched cohorts did not differ in age, sex, body mass index, pathologic diagnosis, and extent of operation. Excised thyroid weight was higher in the Graves' disease than in the control group (60.1 g vs 22.6 g; P <.001). Multivariate analysis showed that Graves' disease significantly increased risks of transient RLN injury (odds ratio [OR] = 4.7, 95% confidence interval [CI] = 1.5-15.5; P =.010) and transient hypoparathyroidism (OR = 2.8, 95% CI = 1.3-5.8; P =.007). Rates of permanent complications were comparable in the Graves' disease and control groups. Conclusions: Graves' disease can be a predictive factor for postoperative RLN injury and hypoparathyroidism after total thyroidectomy.