Incidence and Risk Factors of Postoperative Bleeding in Patients Undergoing Total Thyroidectomy

Abstract

Purpose: Our goal was to analyze postoperative bleeding in patients undergoing total thyroidectomy and to explore the possible risk factors. Materials and Methods: Patients undergoing total thyroidectomy were retrospectively enrolled, and the main study outcomes were postoperative bleeding and 30-day mortality. Univariate and multivariate analyses were used to determine the independent risk factors for postoperative bleeding. Results: A total of 31,706 patients were enrolled for analysis during January 2010 and December 2018 from the Affiliated First Hospital of Zhengzhou University. Benign and malignant disease was reported in 4,521 and 27,185 patients, respectively. Postoperative bleeding occurred in 48 patients with benign disease and in 263 patients with malignant disease. There was one bleeding site in 243 patients. The branch of the superior thyroid artery was the most common arterial bleeding site, occurring in 124 patients, and the anterior jugular vein was the most common venous bleeding site, occurring in 85 patients. Multivariable analysis confirmed that hypertension, diabetes, BMI, and disease pathology were independent factors affecting postoperative bleeding in patients with benign disease and that hypertension, diabetes, BMI, operation time, tumor stage, and tracheotomy were independent factors affecting postoperative bleeding in patients with malignant disease. In patients with postoperative bleeding, there were 5 deaths; in patients without postoperative bleeding, there were 42 deaths, and the difference was significant ( p < 0.001). Conclusions: Compared with malignant disease patients, benign disease patients have a similar postoperative bleeding rate. A previous history of chemotherapy or radiotherapy has no significant effect on postoperative bleeding.

Drainage Tube Placement May Not Be Necessary During Endoscopic Thyroidectomy Bilateral Areola Approach: A Preliminary Report

“…Postoperative hemorrhage is the major severe complication of thyroid surgery that usually occurs within 24 h after surgery (15), which could be fatal considering the rich blood supply and trachea-ahead location of the thyroid. Postoperative hemorrhage after ETBBA is rare, with an incidence rate of 0.32-0.724% (14,15), which is similar to COT (0.43-4.39%) (20,21). The drainage tube was found to be ineffective in preventing postoperative bleeding.…”

Complicaciones en cirugía tiroidea y paratiroidea. Serie retrospectiva

“…Durante los primeros 3 años (2011-2014) la neuromonitorización se realizaba en casos seleccionados (grandes bocios cervicales, extensión retroesternal, cirugía oncológica ganglionar asociada, cirugía de revisión y parálisis laríngea contralateral). A partir del 2014 Ediciones Universidad de Salamanca / [ 4 ] Rev. ORL, 2024, 15, e31749, 1-8 [Publicación continua] la NMIO se realizó de forma sistemática en todos los pacientes.…”

“…ORL, 2024, 15, e31749, 1-8 [Publicación continua] sangrantes. El sangrado arterial es el más común, teóricamente la arteria más frecuentemente afectada es la tiroidea superior [4], no obstante, suele ser bastante frecuente el sangrado en sábana sobre todo a nivel del lecho recurrencial. Es excepcional el tratamiento conservador, únicamente en hematomas superficiales [5].…”

Modern Surgical Techniques of Thyroidectomy and Advances in the Prevention and Treatment of Perioperative Complications

“…Specifically, a case report from the Nippon Medical School in Tokyo described haemophilia A, which showed values of the coagulation determinants PT or aPTT in the normal range. This demonstrates the need to ask during the taking of a history and make a note of any family members with chronic coagulation diseases [123,124,[127][128][129][130][131][132][133]. The risk factors are combined and shown in Table 4.…”

“…However, in highly specialised centres, the rate does not exceed 1% of all operations. Haemorrhages originate from the subcutaneous tissue, subglenoid muscles, upper pole, common jugular vein, tissue adjacent to the retrograde laryngeal nerve, thyroid stump and trachea [122][123][124][125][126][127][128][129].…”