{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:33:11Z","timestamp":1774225991783,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["T32 DC000018"],"award-info":[{"award-number":["T32 DC000018"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Surgery for benign, non\u2010toxic thyroid goiter remains the most common indication for thyroidectomy worldwide, yet the optimal surgical extent remains controversial. While total thyroidectomy is assumed to have greater risks than lobectomy, the difference in complications has not been quantified. The objectives of this study are to (1) compare the risk of surgical complications and (2) quantify the magnitude of this risk difference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective analysis utilizing the National Surgical Quality Improvement Program (NSQIP) Thyroid\u2010Specific Dataset harmonized with the general NSQIP dataset for the years 2016\u20132020. The study was designed to determine if total thyroidectomy is independently associated with postoperative complications when compared to thyroid lobectomy using multivariable analyses controlling for confounding factors. Exposure groups were lobectomy (CPT 60220) and total thyroidectomy (CPT 60240). Outcomes included overall complications, thyroidectomy\u2010specific complications (hypocalcemia prior to discharge, hypocalcemia within 30\u2009days of discharge, clinically severe hypocalcemia, recurrent laryngeal nerve dysfunction, neck hematoma), other surgical complications (infections, wound disruption, and blood transfusion), medical complications, unplanned readmission, reoperation, length of stay, and operative time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight thousand nine hundred twenty\u2010nine thyroidectomies were included: 5052 lobectomies and 3877 total thyroidectomies. Total thyroidectomy was associated with significantly greater odds of any complication (OR\u2009=\u20091.8, CI\u2009=\u20091.5\u20132.2), any thyroidectomy\u2010specific complication (OR\u2009=\u20091.9, CI\u2009=\u20091.6\u20132.3), increased odds of RLN dysfunction (OR\u2009=\u20091.5, CI\u2009=\u20091.2\u20131.9), hypocalcemia prior to discharge (OR\u2009=\u20093.8, CI\u2009=\u20092.2\u20136.7), hypocalcemia after discharge (OR\u2009=\u20094.6, CI\u2009=\u20093.1\u20136.8), and severe hypocalcemia (OR\u2009=\u20095.4, CI\u2009=\u20093.2\u20139.0). Rates of unplanned readmission (OR\u2009=\u20091.5, CI\u2009=\u20091.1\u20132.3), length of hospital stay (+ 0.33\u2009days, CI\u2009=\u20090.1\u20130.5), and operative time (+ 26.1\u2009min. CI\u2009=\u200923.7\u201328.6) were also increased in total thyroidectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this largest study to date, when controlling for comorbidity, extent of disease, and calcium repletion, total thyroidectomy patients had significantly greater rates of surgical and medical complications, as well as readmission. These data should inform shared decision making when determining extent of surgical intervention for this disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.70214","type":"journal-article","created":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T10:39:36Z","timestamp":1753526376000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risks Associated With Extent of Surgical Management for Benign, Non\u2010Toxic Goiter"],"prefix":"10.1002","volume":"10","author":[{"given":"Jacob S.","family":"Brady","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neeraja","family":"Konuthula","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Austin","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-9855","authenticated-orcid":false,"given":"Sean","family":"Massa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery St. Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2070-2005","authenticated-orcid":false,"given":"Zain H.","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Washington School of Medicine  Seattle Washington USA"},{"name":"VA Puget Sound Health Care System  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/8401518"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.01.088"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2013.0291"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262\u2010015\u20101213\u2010z"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010370.pub2"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2017.10.02"},{"key":"e_1_2_8_8_1","unstructured":"American Academy of Otolaryngology \u2013 Head and Neck Surgery Clinical Indicators: Thyroidectomy(2011) https:\/\/www.entnet.org\/wp\u2010content\/uploads\/files\/Thyroidectomy\u2010CI%20Updated%208\u20107\u201014.pdf."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010017\u20104230\u20101"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2013.04.003"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010022\u201006452\u2010w"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010008\u20109579\u20108"},{"issue":"1","key":"e_1_2_8_13_1","first-page":"41","article-title":"Benign Thyroid Disease: 20\u2010Year Experience in Surgical Therapy","volume":"52","author":"Zaraca F.","year":"2000","journal-title":"Chirurgia Italiana"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.50.723"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010221"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.2807"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0543"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.03.022"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556131509400709"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.84.2.5478"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.23736\/S2724\u20106507.20.03203\u20104"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13193\u2010021\u201001467\u20106"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893\u2010019\u20100552\u20102"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14102472"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T04:45:54Z","timestamp":1756442754000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,26]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/lio2.70214"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70214","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,26]]},"assertion":[{"value":"2025-03-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70214"}}