Factors Associated With Neck Hematoma After Thyroidectomy

Suzuki, Shigehiko; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Saito, Yuki; Yamasoba, Tatsuya

doi:10.1097/md.0000000000002812

Cited by 46 publications

(39 citation statements)

References 19 publications

(30 reference statements)

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“…Unlike previous studies suggest that postthyroidectomy haemorrhage increased in patients with malignant pathology (2,13,19,21) or benign pathology (11,12,15,18). We were surprised to find that there was no association between the pathological diagnosis and post-thyroidectomy haemorrhage (OR = 1.07, 95% CI = 0.89-1.28, P = 0.46).…”

Section: Discussionmentioning

confidence: 65%

“…Flow chart of the meta-analysis. (2,4,6,11,12,17). After the analysis, we concluded that the use of antithrombotic agents for thyroidectomy patients, regardless of dosage, was associated with post-thyroidectomy haemorrhage (OR = 1.96, 95% CI = 1.55-2.49, P < 0.00001) ( Fig.…”

Section: Figurementioning

confidence: 87%

“…Compared with conservative methods, thyroid surgery is a relatively safe method for treating several kinds of thyroid diseases; however, the thyroid gland is an organ with a high blood flow rate, and it is not surprising that post-thyroidectomy haemorrhage is a complication of thyroid surgery. The incidence of post-thyroidectomy haemorrhage reported in the literature varies between approximately 0.43% and 4.39% (2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26), but the major centres in developed countries commonly report the incidence of post-thyroidectomy haemorrhage as less than 2%.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for post-thyroidectomy haemorrhage: a meta-analysis

Liu

Sun

Dong

et al. 2017

European Journal of Endocrinology

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Section: Discussionmentioning

confidence: 65%

Section: Figurementioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Risk factors for post-thyroidectomy haemorrhage: a meta-analysis

Liu

Sun

Dong

et al. 2017

European Journal of Endocrinology

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“…Mechanical airway obstruction due to tissue edema or hematoma is a well-recognized surgical complication after various neck surgeries including thyroidectomy [ 138 ] and CEA [ 139 , 140 ]. Particularly during CEA, surgical procedures including dissection, traction, and retraction can injure the facial nerve, hypoglossal nerve, the vagus nerve including its branches (recurrent and superior laryngeal nerves), or glossopharyngeal nerve within the operative field [ 141 – 144 ].…”

Section: Safety Issues Related To Cervical Plexus Blocksmentioning

confidence: 99%

Cervical plexus block

Kim

Bang

et al. 2018

Korean J Anesthesiol

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Cervical plexus blocks (CPBs) have been used in various head and neck surgeries to provide adequate anesthesia and/or analgesia; however, the block is performed in a narrow space in the region of the neck that contains many sensitive structures, multiple fascial layers, and complicated innervation. Since the intermediate CPB was introduced in addition to superficial and deep CPBs in 2004, there has been some confusion regarding the nomenclature and definition of CPBs, particularly the intermediate CPB. Additionally, as the role of ultrasound in the head and neck region has expanded, CPBs can be performed more safely and accurately under ultrasound guidance. In this review, the authors will describe the methods, including ultrasound-guided techniques, and clinical applications of conventional deep and superficial CPBs; in addition, the authors will discuss the controversial issues regarding intermediate CPBs, including nomenclature and associated potential adverse effects that may often be neglected, focusing on the anatomy of the cervical fascial layers and cervical plexus. Finally, the authors will attempt to refine the classification of CPB methods based on the target compartments, which can be easily identified under ultrasound guidance, with consideration of the effects of each method of CPB.

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“…Although thyroid surgery is a relatively safe procedure, it may be associated with some clinically concerning postoperative complications, including postoperative cervical hematoma, incision infection, hypocalcemia, and in some cases vocal cord paralysis. Of these, the development of postoperative cervical hematoma, although rare (incidence: 0.43–6.54%) [2–27], may lead to symptoms of compression causing airway obstruction, respiratory distress, or even death due to suffocation.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for neck hematoma requiring surgical re-intervention after thyroidectomy: a systematic review and meta-analysis

Fan

Zhou

et al. 2019

BMC Surg

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Background In this systematic review and meta-analysis, we aimed to determine the risk factors associated with neck hematoma requiring surgical re-intervention after thyroidectomy. Methods We systematically searched all articles available in the literature published in PubMed and CNKI databases through May 30, 2017. The quality of these articles was assessed using the Newcastle-Ottawa Quality Assessment Scale, and data were extracted for classification and analysis by focusing on articles related with neck hematoma requiring surgical re-intervention after thyroidectomy. Our meta-analysis was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Results Of the 1028 screened articles, 26 met the inclusion criteria and were finally analyzed. The factors associated with a high risk of neck hematoma requiring surgical re-intervention after thyroidectomy included male gender (odds ratio [OR]: 1.86, 95% confidence interval [CI]: 1.60–2.17, P < 0.00001), age (MD: 4.92, 95% CI: 4.28–5.56, P < 0.00001), Graves disease (OR: 1.81, 95% CI: 1.60–2.05, P < 0.00001), hypertension (OR: 2.27, 95% CI: 1.43–3.60, P = 0.0005), antithrombotic drug use (OR: 1.92, 95% CI: 1.51–2.44, P < 0.00001), thyroid procedure in low-volume hospitals (OR: 1.32, 95% CI: 1.12–1.57, P = 0.001), prior thyroid surgery (OR: 1.93, 95% CI: 1.11–3.37, P = 0.02), bilateral thyroidectomy (OR: 1.19, 95% CI: 1.09–1.30, P < 0.0001), and neck dissection (OR: 1.55, 95% CI: 1.23–1.94, P = 0.0002). Smoking status (OR: 1.19, 95% CI: 0.99–1.42, P = 0.06), malignant tumors (OR: 1.00, 95% CI: 0.83–1.20, P = 0.97), and drainage used (OR: 2.02, 95% CI: 0.69–5.89, P = 0.20) were not significantly associated with postoperative neck hematoma. Conclusion: We identified certain risk factors for neck hematoma requiring surgical re-intervention after thyroidectomy, including male gender, age, Graves disease, hypertension, antithrombotic agent use, history of thyroid procedures in low-volume hospitals, previous thyroid surgery, bilateral thyroidectomy, and neck dissection. Appropriate intervention measures based on these risk factors may reduce the incidence of postoperative hematoma and yield greater benefits for the patients.

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Factors Associated With Neck Hematoma After Thyroidectomy

Cited by 46 publications

References 19 publications

Risk factors for post-thyroidectomy haemorrhage: a meta-analysis

Risk factors for post-thyroidectomy haemorrhage: a meta-analysis

Cervical plexus block

Risk factors for neck hematoma requiring surgical re-intervention after thyroidectomy: a systematic review and meta-analysis

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