Causes for early reintervention after thyroidectomy.
BACKGROUND
The purpose of our study was to ascertain the causes for early reintervention after thyroidectomy performed by a surgical team using a systematized surgical technique.


METHODS
We analyzed 1131 patients, 939 (83.1%) women and 192 (16.9%) men, average age 38.7 years (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 lymphatic dissection at levels VI and VII (23.55%). Statistical analysis was performed by main tendency measures and chi square (chi-squared) for comparison of two independent samples; the dependent variable was the rate 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 to acute respiratory failure (ARF) caused by laryngeal edema, resolved by tracheostomy. Analysis based on diagnosis, 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 postoperative monitoring is necessary during the first six hours. The low frequency of early reintervention and the appearance of complications in less than 8 hours enable thyroid surgery to be performed on a short-stay basis with adequate safety margins.
Hurtado-López
Luis Mauricio
LM
Thyroid Clinic, General Surgery Service, Hospital General De México, Mexico. luism.hurtado@mail.internet.com.mx
Zaldivar-Ramirez
Felipe Rafael
FR
Basurto Kuba
Erich
E
Pulido Cejudo
Abraham
A
Garza Flores
Jose Humberto
JH
Muńoz Solis
Oscar
O
Campos Castillo
Carlos
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003953:Diagnosis-Related Groups; D004322:Drainage / Q000706:statistics & numerical data*; D005260:Female; D006406:Hematoma / Q000209:etiology / Q000601:surgery*; D006489:Hemostatic Techniques; D006801:Humans; D007819:Laryngeal Edema / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D011897:Random Allocation; D061226:Recurrent Laryngeal Nerve Injuries; D012131:Respiratory Insufficiency / Q000209:etiology / Q000601:surgery*; D012449:Safety; D013965:Thyroidectomy / Q000379:methods / Q000706:statistics & numerical data; D013997:Time Factors; D014139:Tracheostomy / Q000706:statistics & numerical data*