Abstract
Postoperative bleeding remains one of the most frequent, but rarely life-threatening complications in thyroid surgery. Although arterial bleeding is the main cause of postoperative hemorrhage, most often no actively bleeding vessel can be found during revision. Therefore, the coagulation technique for larger vessels may play a minor role, and hemostatic agents could be of higher importance. In this descriptive, retrospective study, data of 279 patients with thyroid surgery (total of 414 thyroid lobectomies) were collected. We reviewed the electronic medical record by analyzing the histological, operative, laboratory and discharge reports in regards to postoperative bleeding. Of the 414 operated thyroid lobes, 2.4% (n = 10) bled. 1.4% (n = 6) needed reoperation while the other 1.0% (n = 4) could be treated conservatively. Hemostatic patches were applied 286 (69.1%) times. Of the 128 (30.9%) patch-free operated sides, 4.7% (n = 6) suffered postoperative bleeding. Tachosil® alone was used 211 (51.0%) times and bleeding occurred in 1.4% (n = 3). Without statistical significance (p = 0.08) the use of Tachosil® seems to help preventing postoperative bleeding. The combination with other patches doesn’t appear to be more efficient.
Highlights
Postoperative bleeding remains one of the most frequent, but rarely life-threatening complications in thyroid surgery
Data regarding the cases with postoperative bleeding, the device used to obliterate the upper pole vessels, and the application of hemostatic patches are summarized in Tables 3 and 4
Our study further suggests that hemostatic patches are helping in the prevention of postoperative bleeding
Summary
Postoperative bleeding remains one of the most frequent, but rarely life-threatening complications in thyroid surgery. The coagulation technique for larger vessels may play a minor role, and hemostatic agents could be of higher importance. In this descriptive, retrospective study, data of 279 patients with thyroid surgery (total of 414 thyroid lobectomies) were collected. Due to its endocrine function, the thyroid gland is a well perfused organ For this reason, a good hemostasis during surgical procedures is of utmost importance. The frequency of postoperative cervical hematoma (PCH) in thyroid surgery requiring reoperation ranges from 0 to 9.1%4, and it is the most common reason for return to the operating room[5]. The industry provides a variety of devices to seal and cut
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