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

被引:39
作者
Fan, Chunlei [1 ]
Zhou, Xin [1 ]
Su, Guoqiang [1 ]
Zhou, Yanming [2 ]
Su, Jingjun [3 ]
Luo, Mingxu [1 ]
Li, Hui [4 ,5 ]
机构
[1] Xiamen Univ, Affiliated Hosp 1, Xiamen Canc Hosp, Dept Gastrointestinal Surg 3, 55 Zhenhai Rd, Xiamen 361003, Fujian, Peoples R China
[2] Xiamen Univ, Affiliated Hosp 1, Dept Hepatobiliary Surg, Xiamen, Fujian, Peoples R China
[3] Xiamen Univ, Affiliated Hosp 1, Dept Ultrasound, 55 Zhenhai Rd, Xiamen 361003, Fujian, Peoples R China
[4] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Hepat Surg, Guangzhou, Guangdong, Peoples R China
[5] Sun Yat Sen Univ, Affiliated Hosp 3, Liver Transplantat Ctr, Guangzhou, Guangdong, Peoples R China
关键词
Risk factor; Hematoma; Bleeding; Thyroidectomy; Thyroid surgery; POST-THYROIDECTOMY; POSTOPERATIVE HEMATOMA; OUTPATIENT THYROIDECTOMY; ASSOCIATION GUIDELINES; SINGLE-INSTITUTION; SURGERY; MANAGEMENT; COMPLICATIONS; EXPERIENCE; HYPERTHYROIDISM;
D O I
10.1186/s12893-019-0559-8
中图分类号
R61 [外科手术学];
学科分类号
摘要
BackgroundIn this systematic review and meta-analysis, we aimed to determine the risk factors associated with neck hematoma requiring surgical re-intervention after thyroidectomy.MethodsWe 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.ResultsOf 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.
引用
收藏
页数:12
相关论文
共 54 条
  • [1] Clinicopathological Profile, Airway Management, and Outcome in Huge Multinodular Goiters: An Institutional Experience from an Endemic Goiter Region
    Agarwal, Amit
    Agarwal, Sudhi
    Tewari, Prabhat
    Gupta, Sushil
    Chand, Gyan
    Mishra, Anjali
    Agarwal, Gaurav
    Verma, A. K.
    Mishra, S. K.
    [J]. WORLD JOURNAL OF SURGERY, 2012, 36 (04) : 755 - 760
  • [2] [Anonymous], MEDICINE
  • [3] Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists
    Bahn, Rebecca S.
    Burch, Henry B.
    Cooper, David S.
    Garber, Jeffrey R.
    Greenlee, M. Carol
    Klein, Irwin
    Laurberg, Peter
    McDougall, I. Ross
    Montori, Victor M.
    Rivkees, Scott A.
    Ross, Douglas S.
    Sosa, Julie Ann
    Stan, Marius N.
    [J]. THYROID, 2011, 21 (06) : 593 - 646
  • [4] Complications to thyroid surgery:: results as reported in a database from a multicenter audit comprising 3,660 patients
    Bergenfelz, A.
    Jansson, S.
    Kristoffersson, A.
    Martensson, H.
    Reihner, E.
    Wallin, G.
    Lausen, I.
    [J]. LANGENBECKS ARCHIVES OF SURGERY, 2008, 393 (05) : 667 - 673
  • [5] Influence of surgical subspecialty training on in-hospital mortality for gastrectomy and colectomy patients
    Callahan, MA
    Christos, PJ
    Gold, HT
    Mushlin, AI
    Daly, JM
    [J]. ANNALS OF SURGERY, 2003, 238 (04) : 629 - 636
  • [6] Calò PG, 2012, G CHIR, V33, P335
  • [7] Calò PG, 2010, ANN ITAL CHIR, V81, P343
  • [8] Chen ED, 2014, INT J CLIN EXP MED, V7, P1837
  • [9] Chiang Feng-Yu, 2006, Kaohsiung Journal of Medical Sciences, V22, P554
  • [10] Dehal Ahmed, 2015, Perm J, V19, P22, DOI 10.7812/TPP/14-085