Post-Thyroidectomy Hematoma: Risk Factors To Be Considered for Ambulatory Thyroidectomy

Introduction: Post-thyroidectomy hematoma is a serious, potentially life-threatening complication and it is the most frequent indication for reoperation. In this study, we aimed to identify the risk factors and prevalence of post-thyroidectomy hematoma and perform a literature review of the incidence of post-thyroidectomy hematoma at other centers in Saudi Arabia. Methods: We retrospectively enrolled 372 consecutive patients who had undergone thyroidectomy between January 2015 and December 2020. Patients with bleeding disorders were excluded from the study. Data were analyzed using SPSS software, version 20.0 (IBM Corp., Armonk, NY). Results: Three female (0.8%) patients developed a hematoma after thyroidectomy. Two patients developed a hematoma 24 hours after surgery and were treated conservatively. The third patient developed a hematoma within two hours of surgery and required surgical intervention. None of the patients required a tracheostomy, and there was no mortality. No significant association was found between age, sex, final pathology, the extent of thyroidectomy, and risk of hematoma. Conclusion: A post-thyroidectomy hematoma is a rare but dangerous complication. Identifying the risk factors for hematoma formation is of great importance, particularly when considering outpatient thyroidectomy. A large prospective multicenter study is needed for further investigation.