Document Detail

Thyroidectomy in patients at high-risk of bleeding: can it be safely performed?
MedLine Citation:
PMID:  20029354     Owner:  NLM     Status:  MEDLINE    
AIM: This study evaluated the safety of thyroid surgery in patients where anticoagulation was unavoidable or in patients with coagulopathy. METHODS: The records of all patients having high risk of bleeding at the time of thyroidectomy (July 2000 and March 2005) were retrospectively reviewed to evaluate intraoperative and postoperative bleeding. RESULTS: Ten patients were studied. Thyroid lobectomy with isthmusectomy (N=3) and bilateral thyroidectomy (N=7) were performed. Intraoperative surgical hemostasis was meticulous using ligasure vessel sealing system. Patients were divided in 3 groups. Group I (N=2) had small-vessel vasculitis, underwent thyroidectomy under full heparinization. Heparin therapy was continued until full anticoagulation by oral anticoagulants. Group II (N=2) had a documented congenital coagulation defect, had a pre and postoperative special protocols. Group III (N=6) underwent simultaneous thyroid and cardiac surgery (e.g.: intraoperative full heparinization and postoperative antiplatelet therapy in some cases). No extra-bleeding was noted on surgical reports. In the postoperative period, one patient developed a superficial small hematoma in the neck that resolved spontaneously. Transient unilateral laryngeal nerve palsy and transient hypocalcemia were seen in one and two patients respectively. CONCLUSIONS: Thyroidectomy in patients with coagulopathy is feasible with low risk of bleeding if meticulous hemostasis, particularly using ligasure vessel sealing system, is respected.
B Abboud; G Sleilaty; C Braidy; A Melkane; F Nasr
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Minerva chirurgica     Volume:  64     ISSN:  0026-4733     ISO Abbreviation:  Minerva Chir     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-23     Completed Date:  2010-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400726     Medline TA:  Minerva Chir     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  565-71     Citation Subset:  IM    
Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University Beirut, Lebanon.
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MeSH Terms
Blood Coagulation Disorders / complications*
Hemorrhage / etiology,  prevention & control*
Hemostatic Techniques*
Middle Aged
Retrospective Studies
Risk Factors
Thyroidectomy* / adverse effects

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