Postoperative Bleeding Risk in Thyroid Surgery: Differences between Conventional and Endoscopic Video-Assisted Neck...

Area of Science:

• Endocrinology
• Surgical Oncology
• Gastroenterology

Background:

• Postoperative bleeding is a serious complication after thyroidectomy.
• Risk factors and timing of bleeding are not fully understood.
• Bleeding rates for endoscopic thyroidectomy (VANS) in Japan are unclear.

Purpose of the Study:

• To identify risk factors and timing of postoperative bleeding after thyroidectomy.
• To compare bleeding rates and sites between conventional and endoscopic thyroidectomy.

Main Methods:

• Retrospective case-control study.
• Analysis of patients readmitted for postoperative bleeding.
• Multivariate analysis to determine independent risk factors.

Main Results:

• Overall postoperative bleeding rate was 1.85%.
• Antithrombotic therapy (OR 2.95) and dialysis (OR 6.53) were independent risk factors.
• 56.1% of bleeding occurred within 6 hours, 93.0% within 24 hours.
• Endoscopic surgery bleeding rate was 1.6%.
• Bleeding sites differed: thyroid area in conventional, flap area in endoscopic surgery.

Conclusions:

• Antithrombotic therapy and dialysis increase the risk of post-thyroidectomy bleeding.
• Endoscopic thyroidectomy has comparable bleeding rates to conventional surgery.
• The primary site of bleeding differs between surgical approaches.