Objective:  To investigate the surgical complications of total thyroidectomy (TT) and their associated risk factors.
Methods: The clinical data of 172 patients who underwent TT under surgical loupes from January 2007 to December 2009 in our hospital were retrospectively reviewed. The intraoperative and postoperative complications were recorded and the possible factors responsible for surgical complications of TT were analyzed.
Results:  Of the whole group， the exposure rate of the parathyroid glands and the recurrent laryngeal nerves was 96.5% and 98.3%， respectively. The exposure rate of the parathyroid glands of the patients undergoing primary surgery was higher than that of the patients undergoing secondary surgery (98.7% vs. 77.7%) (P＜0.05). The average serum calcium level after surgery decreased significantly compared with that before surgery ［(2.057±0.016) mmol/L vs. (2.347±0.009) mmol/L］ (P＜0.01). In the whole group， the incidence of transient and permanent hypoparathyroidism was 16.9% and 1.2%， respectively. The incidence of permanent hypoparathyroidism in the patients undergoing secondary surgery was significantly higher than that in the patients undergoing primary surgery (11.1% vs. 0) (P＜0.01). The permanent recurrent laryngeal nerve palsy occurred in one case (0.6%).
Conclusions: TT is a safe procedure with low complication rate under the condition of meticulous dissection with the aid of surgical loupes， and is recommended for use in clinical practice.