Incidence and circumstances of cervical hematoma complicating thyroidectomy and its relationship to postoperative vomiting.
BACKGROUND
Cervical hematoma is hardly a predictable complication of thyroid surgery. Postoperative vomiting has been reported as a likely risk factor.


METHODS
Five hundred sixty-two patients undergoing thyroidectomy were prospectively enrolled in the study and divided into 2 groups. Patients in group A received ondansetron to prevent postoperative vomiting. In group B, patients with low vomiting risk received ondansetron whereas patients at high risk received ondansetron plus dexamethasone. Postoperative outcomes of the groups were analyzed and compared.


RESULTS
Cervical hematomas developed in 3 patients (0.53%): 2 in group A and 1 in group B. All hematomas occurred after 6 hours. The incidence of postoperative vomiting was 11.4% in group A and 6.4% in group B (p = .04).


CONCLUSIONS
Careful hemostasis remains of prime importance in preventing cervical hematoma. Postoperative vomiting has not been confirmed by this study as a risk factor for the development of hematoma. Ambulatory thyroid surgery is not advisable.
Bononi
Marco
M
Department of Surgery Pietro Valdoni, University of Rome Sapienza, Rome, Italy.
Amore Bonapasta
Stefano
S
Vari
Alessandra
A
Scarpini
Massimo
M
De Cesare
Alessandro
A
Miccini
Michelangelo
M
Meucci
Massimo
M
Tocchi
Adriano
A
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003907:Dexamethasone / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009333:Neck; D017294:Ondansetron / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D011446:Prospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
D017294:Ondansetron; D003907:Dexamethasone