-Original-

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

Marie Saitou¹, Haruki Akasu², Tomoo Jikuzono¹, Masaomi Sen¹, Hiroko Kazusaka¹, Mami Matsui¹ and Iwao Sugitani¹

¹Department of Endocrine Surgery, Nippon Medical School, Tokyo, Japan
²Department of Endocrine Surgery, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan

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.

J Nippon Med Sch 2024; 91: 432-438

Keywords
postoperative hemorrhage, thyroidectomy, video-assisted surgery, papillary thyroid carcinoma

Correspondence to
Marie Saitou, Department of Endocrine Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
s-marie@nms.ac.jp

Received, April 26, 2024
Accepted, June 17, 2024