title: Left lower limb may be a forbidden region for indwelling needle during operation.
abstract: BACKGROUND
  Information about the incidence and risk factors of venous thromboembolism (VTE) after thyroid operation is limited. This study aimed to analyze the incidence and risk factors of postoperative VTE in patients who had undergone thyroid surgery.
  
  
  METHODS
  A prospective, multi-center cohort study was performed from June 2013 to June 2015 in 3 hospitals throughout South Central China. We analyzed 5029 patients who had undergone thyroid operation and received no VTE prophylaxis postoperatively. For the diagnosis of deep vein thrombosis (DVT), bilateral whole-leg ultrasound was conducted in patients with a high pretest probability of DVT. Lung ventilation/perfusion scintigraphy, pulmonary angiography, or helical computed tomography was implemented in patients suspected to have pulmonary embolism (PE).
  
  
  RESULTS
  DVT was diagnosed in 18 patients (0.36%). No patient was diagnosed with PE. Binomial logistic regression analysis revealed that age and left lower limb intraoperative venous access (IVA) were significant risk factors for DVT. The incidence of DVT increased as the number of risk factors increased.
  
  
  CONCLUSIONS
  VTE is uncommon in patients who have undergone thyroid surgery. The left lower limb was not an appropriate insertion site IVA. Pharmacologic thromboprophylaxis was not mandatory, particularly in those patients without risk factors.
authors.affiliation: Department of Thyroid and Breast Surgery, Tongji Hospital, HuazhongUniversity of Science and Technology, 1095 Jiefang Avenue, Wuhan, PR China.
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Thyroid and Breast Surgery, Tongji Hospital, HuazhongUniversity of Science and Technology, 1095 Jiefang Avenue, Wuhan, PR China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Thyroid and Breast Surgery, Tongji Hospital, HuazhongUniversity of Science and Technology, 1095 Jiefang Avenue, Wuhan, PR China.
authors.forename: Deguang
authors.initials: D
authors.lastname: Kong
authors.affiliation: Department of Thyroid and Breast Surgery, Tongji Hospital, HuazhongUniversity of Science and Technology, 1095 Jiefang Avenue, Wuhan, PR China.
authors.forename: Qiuxia
authors.initials: Q
authors.lastname: Cui
authors.affiliation: Department of Geriatrics, Tongji Hospital, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, PR China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Dongfeng Hospital, Yunyang Medical College, 10 Daling Road, Shiyan, PR China.
authors.forename: Wenbo
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, Yichang People's Hospital Affiliated to Three Gorges University, 10 Jiefang Road, Yichang, PR China.
authors.forename: Shenghua
authors.initials: S
authors.lastname: Cao
authors.affiliation: Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, PR China.
authors.forename: Kongming
authors.initials: K
authors.lastname: Wu
authors.affiliation: Department of Thyroid and Breast Surgery, Tongji Hospital, HuazhongUniversity of Science and Technology, 1095 Jiefang Avenue, Wuhan, PR China. Electronic address: wugaosongtj@163.com.
authors.forename: Gaosong
authors.initials: G
authors.lastname: Wu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects; D011446:Prospective Studies; D012307:Risk Factors; D013961:Thyroid Gland / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D054556:Venous Thromboembolism / Q000209:etiology*
keywords: Incidence; Prophylaxis; Thyroid surgery; Thyroidectomy; Venous thromboembolism