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Updated: Jun 8, 2025

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

Marie Saitou1, Haruki Akasu2, Tomoo Jikuzono1

  • 1Department of Endocrine Surgery, Nippon Medical School.

Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi
|November 6, 2024
PubMed
Summary

Postoperative bleeding after thyroidectomy is linked to antithrombotic therapy or dialysis. Endoscopic surgery shows similar bleeding rates but different bleeding sites compared to conventional methods.

Keywords:
papillary thyroid carcinomapostoperative hemorrhagethyroidectomyvideo-assisted surgery

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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.