title: Incidence and circumstances of cervical hematoma complicating thyroidectomy and its relationship to postoperative vomiting.
abstract: 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.
authors.affiliation: Department of Surgery Pietro Valdoni, University of Rome Sapienza, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bononi
authors.forename: Stefano
authors.initials: S
authors.lastname: Amore Bonapasta
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vari
authors.forename: Massimo
authors.initials: M
authors.lastname: Scarpini
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Cesare
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Miccini
authors.forename: Massimo
authors.initials: M
authors.lastname: Meucci
authors.forename: Adriano
authors.initials: A
authors.lastname: Tocchi
mesh_terms: 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
chemical_list: D017294:Ondansetron; D003907:Dexamethasone