Chronic postsurgical pain following thyroidectomy

Abstract

Background: Chronic postsurgical pain is well recognized after major surgical procedures but often overlooked following thyroidectomy. Given the increasing frequency of this surgery, this systematic review and meta-analysis aimed to synthesize current evidence on the incidence, characteristics, and modulating factors of chronic postsurgical pain after thyroidectomy (CPPT). Methods: A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across 3 electronic databases. Two independent reviewers screened studies for eligibility, extracted data, and assessed methodological quality. Meta-analyses were performed using a random-effects model to estimate pooled incidence rates of CPPT and neuropathic pain. Sensitivity and subgroup analyses were also conducted. Results: After duplicate removal, 241 records were screened, of which 16 studies encompassing 1538 patients met the inclusion criteria. All included studies demonstrated a low risk of bias. The pooled incidence of CPPT at 3 months postoperatively was 18.4%. The pooled incidence of neuropathic pain was 40.9% at 3 months and 9.5% at 6 months postoperatively. Conclusion: The pooled incidence of CPPT was 18.4% at 3 months after thyroidectomy. Neuropathic pain was reported in 40.9% of patients at 3 months and 9.5% at 6 months. Substantial heterogeneity, particularly in the 3-month neuropathic pain estimate, warrants cautious interpretation. These findings highlight CPPT as a clinically relevant but underrecognized complication and support the need for standardized prospective research.