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.

Material/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.