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Article: A review of risk factors and timing for postoperative hematoma after thyroidectomy: is outpatient thyroidectomy really safe?

TitleA review of risk factors and timing for postoperative hematoma after thyroidectomy: is outpatient thyroidectomy really safe?
Authors
Issue Date2012
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal of Surgery, 2012, v. 36 n. 10, p. 2497-2502 How to Cite?
AbstractBACKGROUND: Although postoperative hematoma after thyroidectomy is uncommon, patients traditionally have been advised to stay overnight in the hospital for monitoring. With the growing demand for outpatient thyroidectomy, we assessed its safety and feasibility by evaluating the potential risk factors and timing of postoperative hematoma after thyroidectomy. METHODS: From 1995-2011, 3,086 consecutive patients underwent thyroidectomy at our institution; of these, 22 (0.7 %) developed a postoperative hematoma that required surgical reexploration (group I). Potential risk factors were compared between group I and those without hematoma (n = 3,045) or with hematoma but not requiring reexploration (n = 19; group II). Variables that were significant in the univariate analysis were entered into multivariate analysis by binary logistic regression analysis. RESULTS: Group I was significantly more likely to have undergone previous thyroid operation than group II (27.3 vs. 8.2 %, p = 0.007). The median weight of excised thyroid gland (71.8 vs. 40 g, p = 0.018) and the median size of the dominant nodule (4.1 vs. 3 cm, p = 0.004) were significantly greater in group I than group II. Previous thyroid operation (odds ratio (OR) = 4.084; 95 % confidence interval (CI), 1.105-15.098; p = 0.035) and size of dominant nodule (OR = 1.315; 95 % CI, 1.024-1.687; p = 0.032) were independent factors for hematoma. Sixteen (72.7 %) had hematoma within 6 h, whereas the other 6 (27.3 %) had hematoma at 6-24 h. CONCLUSIONS: Previous thyroid operation and large dominant nodule were independent risk factors for hematoma requiring surgical reexploration. Given that a quarter of hematoma occurred between 6 to 24 h after surgery, routine outpatient thyroidectomy could not be recommended.
Persistent Identifierhttp://hdl.handle.net/10722/152879
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, BHHen_US
dc.contributor.authorYih, PCLen_US
dc.contributor.authorLo, CYen_US
dc.date.accessioned2012-07-16T09:51:07Z-
dc.date.available2012-07-16T09:51:07Z-
dc.date.issued2012en_US
dc.identifier.citationWorld Journal of Surgery, 2012, v. 36 n. 10, p. 2497-2502en_US
dc.identifier.issn0364-2313-
dc.identifier.urihttp://hdl.handle.net/10722/152879-
dc.description.abstractBACKGROUND: Although postoperative hematoma after thyroidectomy is uncommon, patients traditionally have been advised to stay overnight in the hospital for monitoring. With the growing demand for outpatient thyroidectomy, we assessed its safety and feasibility by evaluating the potential risk factors and timing of postoperative hematoma after thyroidectomy. METHODS: From 1995-2011, 3,086 consecutive patients underwent thyroidectomy at our institution; of these, 22 (0.7 %) developed a postoperative hematoma that required surgical reexploration (group I). Potential risk factors were compared between group I and those without hematoma (n = 3,045) or with hematoma but not requiring reexploration (n = 19; group II). Variables that were significant in the univariate analysis were entered into multivariate analysis by binary logistic regression analysis. RESULTS: Group I was significantly more likely to have undergone previous thyroid operation than group II (27.3 vs. 8.2 %, p = 0.007). The median weight of excised thyroid gland (71.8 vs. 40 g, p = 0.018) and the median size of the dominant nodule (4.1 vs. 3 cm, p = 0.004) were significantly greater in group I than group II. Previous thyroid operation (odds ratio (OR) = 4.084; 95 % confidence interval (CI), 1.105-15.098; p = 0.035) and size of dominant nodule (OR = 1.315; 95 % CI, 1.024-1.687; p = 0.032) were independent factors for hematoma. Sixteen (72.7 %) had hematoma within 6 h, whereas the other 6 (27.3 %) had hematoma at 6-24 h. CONCLUSIONS: Previous thyroid operation and large dominant nodule were independent risk factors for hematoma requiring surgical reexploration. Given that a quarter of hematoma occurred between 6 to 24 h after surgery, routine outpatient thyroidectomy could not be recommended.-
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/-
dc.relation.ispartofWorld Journal of Surgeryen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleA review of risk factors and timing for postoperative hematoma after thyroidectomy: is outpatient thyroidectomy really safe?en_US
dc.typeArticleen_US
dc.identifier.emailLang, BHH: blang@hkucc.hku.hken_US
dc.identifier.emailLo, CY: cylo@hkucc.hku.hken_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1007/s00268-012-1682-1-
dc.identifier.pmid22714575-
dc.identifier.pmcidPMC3465547-
dc.identifier.scopuseid_2-s2.0-84867840745-
dc.identifier.hkuros200945en_US
dc.identifier.volume36-
dc.identifier.issue10-
dc.identifier.spage2497en_US
dc.identifier.epage2502en_US
dc.identifier.isiWOS:000309559800029-
dc.publisher.placeUnited States-
dc.identifier.citeulike10842161-

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