Characteristics of Postoperative Bleeding after  Neck Surgery

Nambu, Junko; Sugino, Keizo; Oishi, Koichi; Yano, Mitsuyasu; Nishihara, Masahiro; Dohi, Kiyohiko

doi:10.4236/ss.2013.43036

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…Postoperative bleeding should always be considered surgically related until proven otherwise [20]. The incidence of postoperative bleeding in this study was 7.8% which is higher than in other studies which reported the incidence of less than 2% [21] [22]. There was no significant difference in occurrence of bleeding as far as age, gender and underlying medical condition were concerned.…”

Section: Discussioncontrasting

confidence: 63%

Early Post-Operative Complications in Surgeries Pertaining Oral and Maxillofacial Region in MNH, Tanzania

Sohal¹,

Shubi²

2015

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The Oral and maxillofacial region is one of the complex regions of the body considering the vast anatomical structures that are found in this region; head and neck surgery has potential for many complications, yet inadequate information on occurrence of post-operative complications in oral and maxillofacial surgeries in our setting has been documented. The aim of this study was to determine the occurrence of common early post-operative complications after oral and maxillofacial surgery in relationship to the underlying systemic condition. A descriptive postoperative study was done whereby patients who underwent oral and maxillofacial surgery were included. The included patients were those who underwent surgery for different pathological conditions, trauma, developmental/congenital conditions and inflammatory conditions to mention few. Demographic data, complications developed within one week post operative, and underlying systemic comorbidities before and after surgery were documented and analysed. A total of 102 patients were included in the study. The mean age of participants was 30.00 ± 17.01 years with a range of 2 to 81 years. Majority 43.1% (n = 44) had benign tumors with a leading diagnosis of ameloblastoma. In general, the most common complications which were noted in the cases included Pain 98% (n = 100) and Post-operative Swelling 97.1% (n = 99). The presence of underlying systemic comorbid conditions has a significant role in occurrence of some severe complications. The occurrence of complications does increase the duration of stay in the hospital hence increasing cost of treatment for which bearers are both patients and the hospital.

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Section: Discussioncontrasting

confidence: 63%

Early Post-Operative Complications in Surgeries Pertaining Oral and Maxillofacial Region in MNH, Tanzania

Sohal¹,

Shubi²

2015

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“…Several studies have reported on the site of hemorrhage, but most have not reported distinct bleeding points during the wound exploration. Nambu concluded that the hemorrhage site during postoperative neck surgery mostly occurred on the muscle surface, and excessive muscle subtraction and too much blunt dissection may be the causes of bleeding [18]. The feeding vessels of the vertebral body are often found on the ventral side of the longus colli.…”

Section: Discussionmentioning

confidence: 99%

Risk factor analysis and severity assessment of wound hematoma after anterior cervical spine surgery: A retrospective study

Zhou

Quan

He³

et al. 2020

Preprint

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Background We aim to explore the risk factors independently associated with postoperative wound hematoma in patients who have undergone anterior cervical spine surgery. Methods The clinical data of patients with cervical spondylosis or cervical disc herniation who underwent anterior cervical spine surgery by the senior author from January 2011 to December 2017 were evaluated. Multivariate logistic regression was conducted to compare the hematoma group and the no-hematoma group to determine which factors were independently associated with hematoma formation in patients who need evacuation. The Mann-Whitney U test was conducted to compare the Neck Disability Index score in the two groups. Results A total of 678 patients met the criteria and underwent anterior cervical spine surgery. Thirteen patients undergone hematoma evacuation. Multivariate logistic regression analysis identified that history of hypertension (p = 0.039 OR = 4.42 95% CI 1.08–18.07) and therapeutic heparin use (p = 0.020 OR = 4.58 95% CI 1.27–16.59) were independent risk factors for hematoma formation. The t-test showed no significant differences between the hematoma group and the no-hematoma group in terms of APTT or PT levels (p > 0.05). The Mann-Whitney U test indicated that there was no difference in NDI scores between the two groups(p > 0.05). Conclusion History of hypertension and therapeutic heparin use are risk factors for hematoma formation. Meticulous hemostasis, moderate muscle subtraction, and perioperative airway management are critical for avoiding hematoma development. The Neck Hematoma Scores can quickly determine the severity of a hematoma in the absence of radiographic image evidence.

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“…6 The majority of hemorrhages present within the first 24 hours of surgery. 6,15 Monitoring for postoperative hypocalcemia involves observing for symptoms (perioral/extremities paresthesia and numbness) and signs of hypocalcemia (Chvostek's and Trousseau signs) and serial monitoring of serum/ionized calcium. In some patients, there may be a delayed fall in serum calcium (5-7 days) following surgery.…”

Section: The Roc Curvementioning

confidence: 99%

Next-day Parathyroid Hormone as a Predictor of Post-thyroidectomy Hypocalcemia

Paul¹,

Paul²,

Abraham³

et al. 2016

World Journal of Endocrine Surgery

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Aims Total thyroidectomy is significantly complicated by parathyroid dysfunction and hypocalcemia. These aspects impact the decision regarding the timing of discharge and quantum of calcium supplementation required. Therefore, we aimed at evaluating the accuracy of next-day parathyroid hormone (PTH) level as a predictor of post-thyroidectomy hypocalcemia. Secondly, we aimed at establishing our institution's postoperative PTH level, which can accurately predict the development of post-thyroidectomy hypocalcemia to help us ensure the safe and early discharge of patients. Materials and methods A prospective observational study of 50 continuous patients undergoing thyroidectomy was conducted at a tertiary hospital in South India. Postoperative blood samples were collected for estimation of PTH, calcium, albumin, and phosphorous. The data were collated and results analyzed using Stata I/C 10.1. Results A total of 30% (15/50) of the patients had postoperative hypocalcemia (serum calcium <8 mg/dL). Postoperative PTH was low (<8 pg/mL) in 40% (20/50) of patients. There was a significant association between PTH < 8 pg/mL and the presence of postoperative hypocalcemia (p = 0.029). The area under the receiver operating characteristic (ROC) curve was 0.7, and a next-day PTH of <6 pg/mL showed the highest sensitivity and specificity (83 and 60% respectively) for the development of postoperative hypocalcemia, with a positive predictive value (PPV) and negative predictive value (NPV) of 83 and 60 respectively. Conclusion The PTH assessment performed the day after surgery is an acceptable test to predict post-thyroidectomy hypocalcemia; PTH <6 pg/mL can be used as our institution's cutoff value. Department protocols for calcium and vitamin D supplementation following total thyroidectomy may be formulated based on the appropriately timed local postoperative PTH value to assist safe and early discharge of patients. Clinical significance Discharge protocols for patients undergoing thyroidectomy may be formulated based on the postoperative PTH values, thus enabling safe and early discharge of patients. How to cite this article Cherian AJ, Ramakant P, Paul TV, Abraham DT, Paul MJ. Next-day Parathyroid Hormone as a Predictor of Post-thyroidectomy Hypocalcemia. World J Endoc Surg 2016;8(3):203-207.

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Characteristics of Postoperative Bleeding after Neck Surgery

Cited by 6 publications

References 12 publications

Early Post-Operative Complications in Surgeries Pertaining Oral and Maxillofacial Region in MNH, Tanzania

Early Post-Operative Complications in Surgeries Pertaining Oral and Maxillofacial Region in MNH, Tanzania

Risk factor analysis and severity assessment of wound hematoma after anterior cervical spine surgery: A retrospective study

Next-day Parathyroid Hormone as a Predictor of Post-thyroidectomy Hypocalcemia

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