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

IF 1.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Nippon Medical School Pub Date : 2024-01-01 DOI:10.1272/jnms.JNMS.2024_91-507

Marie Saitou, Haruki Akasu, Tomoo Jikuzono, Masaomi Sen, Hiroko Kazusaka, Mami Matsui, Iwao Sugitani

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引用次数: 0

Abstract

Background: Postoperative bleeding is a potentially life-threatening complication following thyroidectomy, but the risk factors and timing remain insufficiently understood. The bleeding rate for endoscopic surgery, specifically video-assisted neck surgery (VANS), also remains unclear in Japan.

Methods: We conducted a retrospective case-control study of postoperative bleeding requiring readmission to the operating room.

Results: The overall postoperative bleeding rate was 1.85%. Multivariate analysis revealed that postoperative bleeding was independently associated with antithrombotic therapy (odds ratio 2.95; 95% confidence interval 1.15-7.59) and dialysis (odds ratio 6.53; 95% confidence interval 1.75-24.2). Among patients with postoperative bleeding, the complication developed within 6 h in 56.1% and within 24 h in 93.0%. The postoperative bleeding rate in endoscopic surgery was 1.6%. The most common site of bleeding was around the thyroid in conventional surgery and around the flap in endoscopic surgery.

Conclusions: Post-thyroidectomy bleeding is associated with antithrombotic therapy or dialysis. While the bleeding rate in endoscopic surgery is similar to that in conventional surgery, the bleeding site differs.

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甲状腺手术的术后出血风险：传统颈部手术方法与内窥镜视频辅助颈部手术方法的差异。

背景：术后出血是甲状腺切除术后一种可能危及生命的并发症，但人们对其风险因素和发生时间仍不甚了解。在日本，内窥镜手术，特别是视频辅助颈部手术（VANS）的出血率也仍不清楚：我们对需要再次进入手术室的术后出血情况进行了一项回顾性病例对照研究：结果：总体术后出血率为 1.85%。多变量分析显示，术后出血与抗血栓治疗（几率比 2.95；95% 置信区间 1.15-7.59）和透析（几率比 6.53；95% 置信区间 1.75-24.2）独立相关。在术后出血患者中，56.1%的患者在 6 小时内发生并发症，93.0%的患者在 24 小时内发生并发症。内窥镜手术的术后出血率为 1.6%。传统手术最常见的出血部位是甲状腺周围，而内窥镜手术最常见的出血部位是皮瓣周围：结论：甲状腺切除术后出血与抗血栓治疗或透析有关。虽然内窥镜手术的出血率与传统手术相似，但出血部位不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-

CiteScore

1.80

自引率

10.00%

发文量

118

期刊介绍： The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.