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BMC Surg. 2019 Jul 24;19(1):98. doi: 10.1186/s12893-019-0559-8.

Risk factors for neck hematoma requiring surgical re-intervention after thyroidectomy: a systematic review and meta-analysis.

Author information

1
Department of Gastrointestinal Surgery III, Xiamen Cancer Hospital, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, China.
2
Department of Gastrointestinal Surgery III, Xiamen Cancer Hospital, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, China. suguoqiang66@163.com.
3
Department of Hepatobiliary Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China.
4
Department of Ultrasound, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, China. 1208827772@qq.com.
5
Department of Hepatic Surgery and Liver transplantation Center, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Abstract

BACKGROUND:

In this systematic review and meta-analysis, we aimed to determine the risk factors associated with neck hematoma requiring surgical re-intervention after thyroidectomy.

METHODS:

We systematically searched all articles available in the literature published in PubMed and CNKI databases through May 30, 2017. The quality of these articles was assessed using the Newcastle-Ottawa Quality Assessment Scale, and data were extracted for classification and analysis by focusing on articles related with neck hematoma requiring surgical re-intervention after thyroidectomy. Our meta-analysis was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines.

RESULTS:

Of the 1028 screened articles, 26 met the inclusion criteria and were finally analyzed. The factors associated with a high risk of neck hematoma requiring surgical re-intervention after thyroidectomy included male gender (odds ratio [OR]: 1.86, 95% confidence interval [CI]: 1.60-2.17, P < 0.00001), age (MD: 4.92, 95% CI: 4.28-5.56, P < 0.00001), Graves disease (OR: 1.81, 95% CI: 1.60-2.05, P < 0.00001), hypertension (OR: 2.27, 95% CI: 1.43-3.60, P = 0.0005), antithrombotic drug use (OR: 1.92, 95% CI: 1.51-2.44, P < 0.00001), thyroid procedure in low-volume hospitals (OR: 1.32, 95% CI: 1.12-1.57, P = 0.001), prior thyroid surgery (OR: 1.93, 95% CI: 1.11-3.37, P = 0.02), bilateral thyroidectomy (OR: 1.19, 95% CI: 1.09-1.30, P < 0.0001), and neck dissection (OR: 1.55, 95% CI: 1.23-1.94, P = 0.0002). Smoking status (OR: 1.19, 95% CI: 0.99-1.42, P = 0.06), malignant tumors (OR: 1.00, 95% CI: 0.83-1.20, P = 0.97), and drainage used (OR: 2.02, 95% CI: 0.69-5.89, P = 0.20) were not significantly associated with postoperative neck hematoma.

CONCLUSION:

We identified certain risk factors for neck hematoma requiring surgical re-intervention after thyroidectomy, including male gender, age, Graves disease, hypertension, antithrombotic agent use, history of thyroid procedures in low-volume hospitals, previous thyroid surgery, bilateral thyroidectomy, and neck dissection. Appropriate intervention measures based on these risk factors may reduce the incidence of postoperative hematoma and yield greater benefits for the patients.

KEYWORDS:

Bleeding; Hematoma; Risk factor; Thyroid surgery; Thyroidectomy

PMID:
31340806
PMCID:
PMC6657038
DOI:
10.1186/s12893-019-0559-8
[Indexed for MEDLINE]
Free PMC Article

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