Life-threatening neck hematoma complicating thyroid and parathyroid surgery

Rosenbaum, Michael; Haridas, Manjunath; McHenry, Christopher R.

doi:10.1016/j.amjsurg.2007.12.008

Cited by 114 publications

(111 citation statements)

References 11 publications

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“…The incidence of postoperative bleeding in this study was 1.0%, which is similar to that in previous studies (0.1% -1.6%) [2][3][4][5][6][7][8]. Results of several studies have suggested that Basedow's disease is associated with a high risk of postoperative bleeding [9][10][11], though the results are controversial [4,7,12].…”

Section: Discussionsupporting

confidence: 79%

“…Several studies have shown that most hemorrhagic symptoms occurred early in the postoperative period, i.e., within 24 hours [2,[4][5][6]8,12,13]. In this study, postoperative bleeding occurred within 24 hours in all but 2 cases.…”

Section: Discussionmentioning

confidence: 59%

“…We routinely paste a hemostatic agent, oxidized cellulose (SURGICEL * Absorbable Hemostat; Johnson & Johnson K. K., Tokyo, Japan), around the Berry ligament. Closing the strap muscles loosely is thought to be important in wound closing, because the hematoma can be detected in the subcutaneous region [2,4,5]. After closing the wound, we cover it with a small piece of gauze or hydrocolloid dressing to immediately find any neck swelling.…”

Section: Discussionmentioning

confidence: 99%

“…The major complications of neck surgery are recurrent laryngeal nerve injury and hypoparathyroidism, while the most severe complication of neck surgery is postoperative bleeding. The incidence of postoperative bleeding after neck surgery has been reported to be between 0.1% and 1.6% [2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Postoperative Bleeding after Neck Surgery

Nambu¹,

Sugino²,

Oishi³

et al. 2013

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Objective: To review the characteristics of and the procedure for preventing postoperative bleeding after neck surgery. Materials and Methods: A retrospective review of 9 patients (9/893; 1.0%) with postoperative bleeding who required reoperation was performed to analyze clinical findings. Results: There was no significant difference in the incidence of bleeding between types of surgical procedures. Postoperative bleeding occurred within 24 hours in all cases except 2, in which it occurred 7 days or more after the operation. Seven cases showed bleeding from the cut surface of the muscle. Other bleeding points included vessels and the Berry ligament. There were no additional complications after reoperation. Conclusion: When separating the muscles in neck surgery, it is important to sufficiently ligate vessels and induce coagulation with an ultrasonically activated scalpel to prevent postoperative bleeding.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characteristics of Postoperative Bleeding after Neck Surgery

Nambu¹,

Sugino²,

Oishi³

et al. 2013

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“…Its incidence reported varies between 0.1% to 1.4% [1,2]. It may present ten minutes to a week postoperatively, most commonly occurring within 6hrs [3,4]. Its aetiology includes slipping of ligatures, reopening of cauterized veins, vomiting, bucking during recovery, and oozing from residual thyroid tissue [5,6].…”

Section: Discussionmentioning

confidence: 99%

Post- Thyroidectomy Haematoma Causing Severe Supraglottic Oedema and Pulmonary Oedema - A Case Report

Parate

Pujari

Anandaswamy

et al. 2014

JCDR

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Association of Continued Preoperative Aspirin Use and Bleeding Complications in Patients Undergoing Thyroid Surgery

Raggio

Barton

Kandil

et al. 2018

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE No evidence exists to direct the management of preoperative aspirin (acetylsalicylic acid) use in patients undergoing thyroid surgery. Nevertheless, a considerable number of patients interrupt receiving aspirin therapy during the preoperative period to minimize bleeding complications despite the increased risk of experiencing major adverse cardiac events. OBJECTIVE To determine whether aspirin therapy continued preoperatively increases bleeding complications in patients undergoing thyroid surgery. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of a consecutive sample of 570 patients, aged 18 to 100 years, who underwent thyroid surgery for benign and malignant disease from January 1, 2010, to December 31, 2015, by a single surgeon at a tertiary referral hospital center in New Orleans, Louisiana. EXPOSURES Patients receiving aspirin therapy and patients not receiving aspirin therapy (aspirin naive) preoperatively. MAIN OUTCOMES AND MEASURES Comparison of estimated blood loss, substantial blood loss, operative hematoma, nonoperative hematoma, and recurrent laryngeal nerve injury. RESULTS Of 570 patients who underwent thyroid surgery, 106 (18.6%) were performed in patients receiving aspirin; of these, 23 (21.7%) were men and 105 (99.1%) were older than 45 years. Those receiving aspirin therapy displayed a 14.4-year difference in age (95% CI, 11.6-17.1). The aspirin group displayed a 20.3% absolute increase (95% CI, 9.3-30.7) in African American patients. Aspirin therapy was not associated with a statistically significant or clinically meaningful increase in intraoperative blood loss (2.5 mL; 95% CI,-0.4 to 5.3). Aspirin therapy was associated with a statistically significant increase in total hematoma formation (3.3%; 95% CI, 0.4-9.0), but the results were inconclusive. Aspirin therapy was not associated with a statistically significant increase in recurrent laryngeal nerve injury (2.6%; 95% CI,-1.1 to 8.6), but the results were inconclusive. CONCLUSIONS AND RELEVANCE These results suggest that aspirin therapy can be maintained prior to thyroid surgery without increased intraoperative bleeding. Further research with a larger sample size and more outcome events are required to make definitive conclusions regarding the association between aspirin use and complications, including hematoma and recurrent laryngeal nerve injury.

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Life-threatening neck hematoma complicating thyroid and parathyroid surgery

Cited by 114 publications

References 11 publications

Characteristics of Postoperative Bleeding after Neck Surgery

Characteristics of Postoperative Bleeding after Neck Surgery

Post- Thyroidectomy Haematoma Causing Severe Supraglottic Oedema and Pulmonary Oedema - A Case Report

Association of Continued Preoperative Aspirin Use and Bleeding Complications in Patients Undergoing Thyroid Surgery

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