Evaluation of Thyroid Surgery Outcomes and Complications at Teaching Hospitals in the South West Zone

Thyroid surgery, encompassing thyroidectomy for benign and malignant conditions, carries specific risks including recurrent laryngeal nerve injury, hypocalcaemia, and hematoma. Understanding outcomes across institutional settings informs quality improvement efforts in the South West geopolitical zone of Nigeria. This multicenter professional evaluation reviews thyroid surgery outcomes and complications at three teaching hospitals in Ogun, Oyo, and Osun states from 2020 to 2023. A retrospective pooled analysis of 320 thyroidectomy records was conducted. Outcome measures included rates of recurrent laryngeal nerve palsy, hypocalcaemia, surgical site infection, haematoma, and hospital stay duration. Operative technique (total versus subtotal thyroidectomy) and surgeon experience level were examined as covariates. Temporary recurrent laryngeal nerve palsy occurred in 9.1% of cases, with 1.9% permanent. Postoperative hypocalcaemia was documented in 18.4% of cases. Senior consultants had significantly lower complication rates than registrars (p=0.009). Total thyroidectomy was associated with higher complication rates but better oncological outcomes in malignant cases. The study recommends mandatory intraoperative nerve monitoring at all thyroid surgery centers, a regional thyroid surgery quality registry, and supervised thyroid surgery training pathways for registrars in South West Nigeria. Keywords: thyroidectomy, thyroid complications, nerve monitoring, South West Nigeria, surgical quality