| Thyroidectomy in patients at high-risk of bleeding: can it be safely performed? | |
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MedLine Citation:
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PMID: 20029354 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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B Abboud; G Sleilaty; C Braidy; A Melkane; F Nasr |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Minerva chirurgica Volume: 64 ISSN: 0026-4733 ISO Abbreviation: Minerva Chir Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-23 Completed Date: 2010-06-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0400726 Medline TA: Minerva Chir Country: Italy |
Other Details:
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Languages: eng Pagination: 565-71 Citation Subset: IM |
Affiliation:
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Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University Beirut, Lebanon. dbabboud@yahoo.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Blood Coagulation Disorders / complications* Female Hemorrhage / etiology, prevention & control* Hemostatic Techniques* Humans Male Middle Aged Retrospective Studies Risk Factors Thyroidectomy* / adverse effects |
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