Postoperative hematomas after thyroid surgery. Incidence and risk factors in our experience

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COD: 343-348 Categorie: ,

Pietro Giorgio Calò, Giuseppe Pisano, Gabriele Piga, Fabio Medas, Alberto Tatti, Marcello Donati, Angelo Nicolosi

Ann. Ital. Chir., 2010 81: 343-347

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AIM: The aim of our study was to evaluate the incidence and timing of postoperative bleeding and to identify the potential
aetiological factors of cervical hematomas complicating thyroid surgery.
MATERIAL: Between September 2002 and December 2009, 2559 patients were operated on in Department of Surgery,
University Hospital of Cagliari. 2257 total thyroidectomies, 191 total thyroidectomies associated to lymphadenectomy, 83
total thyroidectomies associated to parathyroidectomy, 24 thyroid lobectomies and 4 lobectomies associated to parathyroidectomy
were performed.
RESULTS: 35 Patients (1.36%) developed a postoperative hematoma, 32 of whom (1.25%) needed a surgical revision.
Male sex seemed to have a greater risk: 13 men (2.79% of all males) vs. 19 women (0.90% of all female cases) had
to undergo haemostasis revision (p=0.00204). 16 of 32 patients (50%) who underwent surgical revision had hypertension;
incidence of hematoma was 2.09% in patients with hypertension and 0.89% in patients without it (p=0.02112)
DISCUSSION: It is generally difficult to predict which patients are at risk for the development of a hematoma after thyroid
surgery. The most intense postoperative monitoring is necessary during the first six hours but hematomas occurring
after are not rare.
CONCLUSIONS: Postoperative hematoma remains a rare but potentially life-threatening complication. Early recognition
with immediate intervention is the key to the management of this complication. Because of the possibly long interval
between the initial operation and the hematoma development, ambulatory and one-day thyroid surgery is not advisable.

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