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Risk of bleeding after thyroid surgery: matched pairs analysis

Published online by Cambridge University Press:  05 July 2011

R P Morton*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
V Mak
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
D Moss
Affiliation:
Department of Surgery, Counties Manukau District Health Board, Auckland, New Zealand
Z Ahmad
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
J Sevao
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
*
Address for correspondence: Dr Randall P Morton, PO Box 98743, South Auckland Mail Centre, Auckland, New Zealand E-mail: RPMorton@middlemore.co.nz

Abstract

Objective:

To identify those patients most at risk of developing a compressive post-operative haematoma following thyroid surgery.

Method:

Retrospective analysis of patients undergoing thyroid surgery. Factors associated with the group of patients who developed a post-operative haematoma were examined using a matched pairs, case–control design.

Results:

Following 355 thyroid operations, seven patients developed a post-operative haematoma requiring return to the operating theatre for bleeding control. A post-operative systolic blood pressure of greater than 150 mmHg, in the post-anaesthetic care unit, was the major significant factor identified by regression analysis (p = 0.002). Current smoking status was also a significant factor (p = 0.04).

Conclusion:

In our facility, a post-anaesthetic systolic blood pressure in excess of 150 mmHg was associated with an increased risk of haemorrhage following thyroid surgery.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Rosenbaum, MA, Haridas, M, McHenry, CR. Life-threatening neck hematoma complicating thyroid and parathyroid surgery. Am J Surg 2008;195:339–43CrossRefGoogle ScholarPubMed
2Reeve, T, Thompson, NW. Complications of thyroid surgery: how to avoid them, how to manage them, and observations on their possible effect on the whole patient. World J Surg 2000;24:971–5Google Scholar
3Rosato, L, Avenia, N, Bernante, P, De Palma, M, Gulino, G, Nasi, PG et al. Complications of thyroid surgery analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 2004;28:271–6CrossRefGoogle Scholar
4Pieracci, FM, Faley, TJ. Effect of hospital volume of thyroidectomies on outcomes following substernal thyroidectomy. World J Surg 2008;32:740–6Google Scholar
5Emre, AU, Cakmak, GK, Tascilar, O, Ucan, BH, Irkorucu, O, Karakaya, K et al. Complications of total thyroidectomy performed by surgical residents versus specialist surgeons. Surg Today 2008;38:879–85CrossRefGoogle ScholarPubMed
6Sosa, JA, Mehta, PJ, Wang, TS, Boudourakis, L, Roman, SA. A population-based study of outcomes from thyroidectomy in aging Americans: at what cost? J Am Coll Surg 2008;206:1097–105CrossRefGoogle ScholarPubMed
7Martin, L, Delbridge, L, Martin, J, Poole, A, Crummer, P, Reeve, T. Trainee surgery in teaching hospitals: is there a cost? Aust N Z J Surg 1989;59:257–60CrossRefGoogle ScholarPubMed
8Shaha, A, Jaffe, BM. Complications of thyroid surgery performed by residents. Surgery 1988;104:1109–14Google Scholar
9Bononi, M, Bonapasta, SA, Vari, A, Scarpini, M, De Cesare, A, Miccini, M et al. Incidence and circumstances of cervical hematoma complicating thyroidectomy and its relationship to postoperative vomiting. Head Neck 2010;32:1173–7CrossRefGoogle ScholarPubMed
10Agarwal, A, Mishra, SK. Completion total thyroidectomy in the management of differentiated thyroid carcinoma. Aust N Z J Surg 1996;66:358–60Google Scholar
11Chi, SY, Hsei, KC, Sheen-Chen, SM, Chou, FF. A prospective randomized comparison of bilateral subtotal thyroidectomy versus unilateral total and contralateral subtotal thyroidectomy for Graves' disease. World J Surg 2005;29:160–3CrossRefGoogle ScholarPubMed
12Matory, YL, Spiro, RH. Wound bleeding after head and neck surgery. J Surg Oncol 1993;53:1719Google Scholar
13Basto, ER, Waintrop, C, Mourey, FD, Landru, JP, Eurin, BG, Jacob, LP. Intravenous detoprofen in thyroid and parathyroid surgery. Anesth Analg 2001;92:1052–7CrossRefGoogle ScholarPubMed
14Burkey, SH, van Heerden, JA, Thompson, GB, Grant, CS, Schleck, CD, Farley, DR. Reexploration for symptomatic hematomas after cervical exploration. Surgery 2001;130:914–20CrossRefGoogle ScholarPubMed
15Bergamaschi, R, Becouam, G, Ronceray, J, Arnaud, JP. Morbidity of thyroid surgery. Am J Surg 1998;176:71–5Google Scholar
16Lacoste, L, Gineste, D, Karayan, J, Montaz, N, Lehuede, MS, Girault, M et al. Airway complications in thyroid surgery. Ann Otol Rhinol Laryngol 1993;102:441–6Google Scholar
17Samraj, K, Gurusamy, KS. Wound drains following thyroid surgery. Cochrane Database Syst Rev 2007;(4):CD006099. DOI: 10.1002/14651858.CD006099.pub2.Google Scholar
18Prim, MP, De Diego, JI, Hardisson, D, Madero, R, Gavilan, J. Factors related to nerve injury and hypocalcemia in thyroid gland surgery. Otolaryngol Head Neck Surg 2001;124:111–14CrossRefGoogle ScholarPubMed
19Spinelli, C, Berti, I, Miccoli, P. The postoperative hemorrhagic complication in thyroid surgery. Minerva Chir 1994;49:1245–7Google ScholarPubMed
20Lee, HS, Lee, BJ, Kim, SW, Cha, YW, Choi, YS, Park, YH et al. Patterns of post-thyroidectomy hemorrhage. Clin Exp Otorhinolaryngol 2009;2:72–7Google Scholar
21Moumoulidis, I, Martinez del Pero, M, Brennan, L, Jani, P. Haemostasis in head and neck surgical procedures: Valsalva manoeuvre versus Trendelenbug tilt. Ann R Coll Surg Engl 2010;92:292–4Google Scholar
22Petrakis, IE, Kogerakis, NE, Lasitheotakis, KG, Vrachassotakis, N, Chalkiadakis, GE. LigaSure verus clamp-and-tie thyroidectomy for benign nodular disease. Head Neck 2004;26:903–9CrossRefGoogle Scholar
23Harding, J, Sebag, F, Sierra, M, Palazzo, FF, Henry, JF. Thyroid surgery postoperative hematoma prevention and treatment. Langenbecks Arch Surg 2006;391:169–73Google Scholar