This article is more than 5 years old. Information may no longer be current.
High BMI did not increase risk for surgical complications in thyroidectomy
Click Here to Manage Email Alerts
In patients undergoing minimally invasive video-assisted thyroidectomy, high BMI did not appear to yield increased risk for surgical complications, according to recent findings.
In a retrospective review published in Thyroid, researchers accessed a prospective database of all thyroid surgeries performed between 2006 and June 2012 and identified all minimally invasive video-assisted thyroidectomy (MIVAT) procedures performed during that time. They identified 233 MIVATs performed on 223 patients. Patients were selected for MIVAT based on a thyroid volume ≤20 mL, the presence of a dominant nodule ≤3 cm, along with no evidence of thyroiditis or substernal extension.
Patients were stratified into three BMI categories as defined by NIH guidelines: normal (BMI ≤24.9), overweight (BMI 25-29.9) and obese (BMI ≥30). The researchers compared the total number of surgical complications seen among the three groups along with complications from MIVAT with those observed in a conventional thyroid surgery cohort. Also evaluated were operative times, incision length and medical comorbidities.
Study findings demonstrated that for the study population, the mean overall BMI was 25.4. There were 123 procedures (52.8%) performed on nonobese patients, 76 procedures (32.6%) were done on overweight patients and 34 procedures (14.6%) were performed on obese patients. Adverse events included the following: one case of cellulitis (0.4%), six cases of temporary hypocalcemia (2.6%) and six cases of transient vocal fold paresis (2.6%). None of the cases of hypocalcemia were permanent, and no patients sustained a permanent laryngeal nerve injury. Of the complications, nine (7.3%) were in the normal group, four (5.3%) were in the overweight group and none occurred in the obese group. To further investigate the low number of complications seen in this study, the investigators combined the overweight and obese groups into a single high-BMI group. After statistical analysis using logistic regression models, findings showed that there was no significant difference in number of complications for the high-BMI patients vs. normal BMI patients (OR=0.48; CI, 0.14-1.63).
Notably, there were fewer overall complications in the MIVAT group than the conventional thyroidectomy cohort. “MIVAT patients experienced fewer complications than conventional thyroidectomy patients, even when MIVAT patients with a high BMI were included in the analysis,” the researchers wrote. “Given these outcomes, we conclude that in the appropriately selected patient, a high BMI does not appear to impart any additional risk of complication for patients undergoing MIVAT.”
Disclosure: One researcher reports financial ties with Johnson & Johnson.
Click Here to Manage Email Alerts