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Management von Nachblutungen nach Schilddrüsenoperationen

Management of postoperative hemorrhage following thyroid surgery

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Zusammenfassung

Die Inzidenz postoperativer Blutungen nach Schilddrüsenoperationen liegt bei 1–2 %. Die niedrige Frequenz kontrastiert stark mit den erheblichen potenziellen Komplikationen der Nachblutung. Einflussfaktoren und Maßnahmen aus der Literatur und eigenen Untersuchungen werden diskutiert. Indirekt kann eine Verbesserung der Nachblutungsrate angenommen werden, da Operationen zunehmend unter gerinnungsrelevanter Medikation durchgeführt werden. Dennoch besteht keine Inzidenzzunahme, aber auch kein Rückgang der daraus resultierenden Komplikationen, vorrangig Rekurrensparese, Tracheotomie und Mortalität. Chirurgische Einflussfaktoren sind penible Technik, Sorgfalt sowie Sicherstellung der für mindestens 4–6 h intensiven und qualifizierten postoperativen Überwachung, die jederzeit eine umgehende operative Revision ermöglicht.

Abstract

The incidence of postoperative hemorrhage following thyroid surgery stands at 1%–2 %. This low incidence contrasts with the significant potential complications of postoperative hemorrhage. Influencing factors and measures mentioned in the literature and own studies are discussed. Although an improvement in the postoperative hemorrhage rate was to be expected indirectly due to the increasing use of coagulation-relevant medication, there has been neither an increase in incidence nor a reduction in resultant complications, including primarily recurrent vocal cord paresis, tracheotomy and mortality. Factors that influence surgical success include a meticulous technique and caution, as well as ensuring intensive and qualified postoperative monitoring for a minimum of 4–6 h, thereby permitting immediate revision surgery at any time.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Lorenz, C. Sekulla, J. Kern und H. Dralle geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Universitätsklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland

    K. Lorenz, C. Sekulla, J. Kern & H. Dralle

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  1. K. Lorenz
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  2. C. Sekulla
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  3. J. Kern
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  4. H. Dralle
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Correspondence to K. Lorenz.

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Lorenz, K., Sekulla, C., Kern, J. et al. Management von Nachblutungen nach Schilddrüsenoperationen. Chirurg 86, 17–23 (2015). https://doi.org/10.1007/s00104-014-2818-7

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  • DOI: https://doi.org/10.1007/s00104-014-2818-7

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