Hemorrhagic complications in thyroid surgery

In order to establish the influence of either the extent of surgery or the thyroid pathology on the incidence of postoperative hemorrhage, a series of 1386 subsequent thyroidectomies is verified. Although hemorrhage is widely considered a fortuitous and unforseeable event, according to the data collected in the present stndy, higher incidence of haemorrhagic complications occurred in Basedow disease and reoperations: respectively 4.3 and 2.4% vs 0.5% of the whole series; however a significant statistical difference arose only in hyperthyroid patients. The importance of: preoperative treatment of hyperthyroidism, intraoperative meticulous dissection and hemostasis, and surveillance in the early postoperative period is remarked. Not unnecessary is considered the role of suction drains. An immediate evacuation is required by the compressive neck hematoma: the ligation of the inferior thyroid artery laterally, close to the common carotid, is helpful if the source of bleeding is unrecognizable.