Hashimoto's thyroiditis as a risk factor of complications of total thyroidectomy

Background Hashimoto's thyroiditis (HT), a type of chronic lymphocytic thyroiditis, is the most common autoimmune thyroid condition. The diagnosis is primarily made on the basis of serum autoantibodies against thyroid peroxidase and/or thyroglobulin, which may precede clinical symptoms and biochemical hypothyroidism by several years. Medical treatment is usually the choice for most patients with HT. However, surgical intervention may be needed. Surgery for patients with HT tends to be more difficult and riskier as the thyroid gland tends to adhere more to its anatomical surroundings, which results in a higher rate of postoperative complications. Patients and methods A total of 46 patients who had undergone surgery for benign thyroid diseases from December 2021 to May 2022 were included. Group A consisted of 25 patients who had HT, and group B consisted of 21 patients operated for nonmalignant thyroid diseases. Results Patients with HT were younger and more likely to be female. The mean operative time was longer in group A than in group B, and also the mean intraoperative blood loss was higher in the HT group than the non-HT group. Patients who underwent thyroidectomy with HT had also a significantly higher rate of postoperative complications. Conclusions Patients with HT had a higher rate of complications after thyroidectomy when compared with patients without HT. Therefore, careful consideration must be taken before pursuing operative treatment in patients with HT, including providing adequate informed consent regarding the increased risks of surgery.