title: Effect of Intraoperative Valsalva Maneuver Application on Bleeding Point Detection and Postoperative Drainage After Thyroidectomy Surgeries.
abstract: The purpose of this paper was to analyze the effect of Valsalva maneuver application before finalizing thyroidectomy operations on the identification of bleeding points and postoperational drainage. One hundred patients (age range, 24-76 years) with multinodular goiter, recurrent multinodular goiter, toxic diffuse multinodular goiter, or papillary thyroid cancer were included in the study and were divided into 2 groups of 50 randomly. Both groups underwent thyroidectomy operation, only 1 group received intraoperative Valsalva maneuver application (twice, 30 seconds of 30-cm PEEP). The size of the thyroid gland, the duration of operation, hospital stay, and drain usage were reported. Postoperational occurrences of drainage, hematoma, reoperation, and additional complications were compared between the groups. Valsalva maneuver application helped to identify minor bleeding points in 32% of the cases. There was no significant difference between the study groups regarding the thyroid gland size, operation duration, hospital stay, and the duration of drain usage (P > 0.05 for all). The amount of drainage as well as the frequencies of hematoma, reoperation, and further complications was not significantly different between the study groups (P > 0.05 for all). Intraoperative application of Valsalva maneuver is only useful to detect minor bleeding points in some patients during thyroidectomy operations, but it had no effect on the duration of postoperative drain usage, the amount of drainage, and risk of hematoma. Therefore, intraoperative application of Valsalva maneuver has no beneficial effect on postoperative hemorrhagic complication after thyroidectomy operations.
authors.affiliation: 1 Ankara Atatürk Training and Research Hospital, Clinics of General Surgery, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tokaç
authors.affiliation: 1 Ankara Atatürk Training and Research Hospital, Clinics of General Surgery, Ankara, Turkey.
authors.forename: Ersin Gürkan
authors.initials: EG
authors.lastname: Dumlu
authors.affiliation: 1 Ankara Atatürk Training and Research Hospital, Clinics of General Surgery, Ankara, Turkey.
authors.forename: Birkan
authors.initials: B
authors.lastname: Bozkurt
authors.affiliation: 1 Ankara Atatürk Training and Research Hospital, Clinics of General Surgery, Ankara, Turkey.
authors.forename: Haydar
authors.initials: H
authors.lastname: Öcal
authors.affiliation: 2 Department of Endocrinology and.
authors.forename: Cevdet
authors.initials: C
authors.lastname: Aydın
authors.affiliation: 3 Department of General Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey.
authors.forename: Abdussamed
authors.initials: A
authors.lastname: Yalçın
authors.affiliation: 2 Department of Endocrinology and.
authors.forename: Bekir
authors.initials: B
authors.lastname: Çakır
authors.affiliation: 3 Department of General Surgery, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kılıç
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D006042:Goiter / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome; D014636:Valsalva Maneuver
keywords: Drainage; Hemostasis; Thyroidectomy; Valsalva maneuver