Wojtczak B, et al. - The intention of the authors was to investigate the risk factors of severe complications in the surgical treatment of thyroid gland diseases. It was determined that bleeding after thyroid operations was a direct life threat warranting immediate intervention. Half of the patients suffered from other complications and some required intensive care. The highest risk was noted in the case of male sex, toxic goiter and total resection of the thyroid gland. Data recommended close monitoring of each patient after thyroid surgery. Furthermore, an operating theatre and Intensive Care Unit (ICU) ought to be available at all times.

Methods

• An inquiry was carried out of 7,805 thyroid operations performed from 1996 to 2014 in the Clinic of General, Gastroenterological and Endocrine Surgery of Wroclaw Medical University.
• Data analysis included typical risk factors, symptoms and consequences of bleeding.

Results

• Among the enrollees, 88.2% were female and 11.8% male.
• The occurrence of bleeding was noted in 84 (1.08%) patients.
• The prominent risk factors for bleeding included sex (p=0.006), preoperative thyroid pathology (p=0.03), and type of operation (p < 0.001).
• This was not the case with retrosternal goiter and surgeon’s experience.
• Findings exhibited highest risk of bleeding in the case of male sex, toxic goiter and total resection of the thyroid gland.
• It was determined that maximum reoperations took place within 6 h.
• In 88.8% of cases of this kind of complication, the surgeon indicated the exact source of bleeding, which was most commonly the neck muscles, skin and subcutaneous tissue, or the thyroid stump.
• As per the results, 3 candidates required a second reoperation, 24 suffered additional complications, and 8 needed transfer to the Intensive Care Unit (ICU).
• Data demonstrated the occurrence of cardiac arrest in 3 patients and herein 2 subjects suffered bilateral vocal cord palsy.