Thyroid Surgery and Anticoagulation: Survey of Practice of Endocrine Surgeons in Australia

Abstract

Few studies specifically address management of venous thromboembolism (VTE) prophylaxis and bridging anticoagulation therapy in patients undergoing thyroid surgery. A survey about perioperative management of thromboprophylaxis was sent to Australian Endocrine Surgeons. Responses were tabulated and graphed; a p-value of < 0.05 was considered statistically significant. Survey responses showed a large broad spectrum of practice regarding thromboprophylaxis, bridging therapy and cessation of anticoagulant medication. While anticoagulant prophylaxis in thyroid surgery appears to be relatively safe, there is a theoretical risk of catastrophic bleeding complications; according to this survey of Australian Endocrine Surgeons, thromboembolic events are uncommon complications of thyroid surgery.

The perioperative management of anticoagulants and antiplatelet agents in cervical and adrenal surgery

“…There is therefore no indication of systematic post-operative medicinal thromboembolic prophylactic treatment [1]. This can be individually indicated according to particular thromboembolic and haemorrhagic risk factors [2,3]. (Level of evidence: 4).…”

Letter to the Editor: Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management

“…Although good general guidance exists on quantifying the risks of bleeding and thromboembolism to inform peri‐operative planning, this has not been specifically or satisfactorily addressed in neck endocrine surgery and wide variation in practice in those undertaking neck endocrine surgery has been reported [5].…”