Consequences of bleeding after thyroid surgery – analysis of 7805 operations performed in a single center

Abstract

IntroductionSurgical treatment of thyroid gland diseases is associated with the possibility of severe complications. The most dangerous of them is bleeding. Current studies focus on its risk factors, rather than reoperation-related consequences.Material and methodsWe analyzed 7805 thyroid operations performed from 1996 to 2014 in the Clinic of General, Gastroenterological and Endocrine Surgery of Wroclaw Medical University. Typical risk factors, symptoms and consequences of bleeding were analyzed.ResultsAmong operated patients 88.2% were female and 11.8% male. Bleeding occurred in 84 (1.08%) patients. Sex (p = 0.006), preoperative thyroid pathology (p = 0.03), and type of operation (p < 0.001) are significant risk factors for bleeding, while retrosternal goiter and surgeon’s experience are not. Risk of bleeding is highest in the case of male sex, toxic goiter and total resection of the thyroid gland. Most reoperations took place within 6 h. In 88.8% of cases of this kind of complication the surgeon indicated the exact source of bleeding; most commonly it was the neck muscles, skin and subcutaneous tissue, or the thyroid stump. Three patients required a second reoperation, 24 suffered further complications, and 8 required transfer to the Intensive Care Unit (ICU). Cardiac arrest occurred in 3 patients and 2 suffered bilateral vocal cord palsy.ConclusionsBleeding after thyroid operations is a direct life threat that requires immediate intervention. As a result death may occur, half of patients suffer other complications and some require intensive care. The risk is highest in the case of male sex, toxic goiter and total resection of the thyroid gland. Each patient after thyroid surgery needs to be closely observed. An operating theatre and ICU should be available at all times.

Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery

“…In the CON group, there was a 1.7% incidence of cervical hematoma and need for surgical revision. Reductions of postoperative bleeding and potential consequences contributed to patients’ recovery who underwent thyroid surgery [27]. In our study, the volume of drainage within 48 h after surgery was lower in the two treatment groups than that in the CON group, as a result that the time to removal of drainage and the postoperative length of hospital stay in the CON group were longer than these in two treatment groups.…”

Extending expressed RNA genomics from surgical decision making for cytologically indeterminate thyroid nodules to targeting therapies for metastatic thyroid cancer

“…Consequently, most of these surgeries generated unnecessary direct and indirect medical costs, patient anxiety and diminished productivity during recovery, and complications. Although high‐volume thyroid surgeons report relatively low surgical complication rates of 1% to 3%, approximately 26% to 81% of patients undergo surgery with low‐volume surgeons whose complication rates generally are much higher, including hypothyroidism, clinically severe hypocalcemia/hypoparathyroidism, recurrent laryngeal nerve injury, and, less commonly, infection and bleeding . Higher surgical complication rates have been reported among the elderly, who are heavily represented in the thyroid nodule population.…”

Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery

“…In the CON group, there was a 1.7% incidence of cervical hematoma and need for surgical revision. Reductions of postoperative bleeding and potential consequences contributed to patients' recovery who underwent thyroid surgery [27]. In our study, the volume of drainage within 48 hours after surgery was lower in the two treatment groups than that in the CON group, as a result that the time to removal of drainage and the postoperative length of hospital stay in the CON group were longer than these in two treatment groups.…”