Luis Mauricio Hurtado-López, Felipe Rafael Zaldivar-Ramirez, Erich Basurto Kuba, Abraham Pulido Cejudo, Jose Humberto Garza Flores, Oscar Muńoz Solis, Carlos Campos Castillo
Med Sci Monit 2002; 8(4): CR247-250
BACKGROUND: The purpose of our study was to ascertain the causes for earlyreintervention after thyroidectomy performed by a surgical team using a systematized surgical technique.MATERIAL/METHODS: We analyzed 1131 patients, 939 (83.1%) women and 192 (16.9%) men, average age 38.7years (range 12 to 79). Of these patients, there were 675 hemithyroidectomies with isthmusectomy (59.74%),189 subtotal thyroidectomies (16.71%), and 267 total thyroidectomies, alone or with regional lymphaticdissection at levels VI and VII (23.55%). Statistical analysis was performed by main tendency measuresand chi square (chi-squared) for comparison of two independent samples; the dependent variable was therate of early reintervention, while the independent variables included causes, time of presentation,hormonal functional state and extent of surgery. RESULTS: Early reintervention was necessary in 11 cases(0.97%). 9 were due to hematoma (0.79%) resolved with drainage and hemostasis, and two (0.18%) due toacute respiratory failure (ARF) caused by laryngeal edema, resolved by tracheostomy. Analysis based ondiagnosis, extent of surgery and functional state failed to reveal statistically significant differences.The maximum time presentation of complications was 6 hours. CONCLUSIONS: The most intense postoperativemonitoring is necessary during the first six hours. The low frequency of early reintervention and theappearance of complications in less than 8 hours enable thyroid surgery to be performed on a short-staybasis with adequate safety margins.
Keywords: Adolescent, Adult, Aged, Child, Comparative Study, Diagnosis-Related Groups, Drainage, Female, Hematoma, Hemostatic Techniques, Humans, Laryngeal Edema, Length of Stay, Longitudinal Studies, Male, Middle Aged, Postoperative Care, Postoperative Complications, Prospective Studies, Random Allocation, Recurrent Laryngeal Nerve, Respiratory Insufficiency, Safety, Thyroidectomy, Time Factors, Tracheostomy