Ramouz Ali, Rasihashemi Seyed Ziaeddin, Daghigh Faeze, Faraji Esmaeil, Rouhani Shahin
Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Physiology, Tabriz University of Medical Sciences, Tabriz, Iran.
Ann Med Surg (Lond). 2017 Sep 18;23:8-12. doi: 10.1016/j.amsu.2017.09.001. eCollection 2017 Nov.
Seroma is defined as collection of fluid within the surgical site during postoperative period that causes several complications. Recognition of predisposing risk factors can lead to avoid seroma formation after thyroidectomy.
A cross-sectional study was carried out during a 3-year period and 678 patients were enrolled the study. We recorded demographic data, past medical history and the type of thyroidectomy were for all patients. We measured total and ionized serum calcium and albumin level in all patients before surgery and a day after it. All patients underwent total or subtotal thyroidectomy and if needed central neck dissection was performed subsequently. Patients underwent serial aspiration If they had seroma formation.
The overall post-thyroidectomy seroma incidence was 2.2%. There was no statistically significant correlation while evaluating gender, age and body mass index with post-operative seroma formation. However, seroma formation was significantly higher in patients underwent total thyroidectomy (P = 0.041). The results of postoperative laboratory tests showed a significant lower level of ionized calcium in patients with seroma formation (P < 0.0001). Logistic regression showed statistically significant value for variables including age, BMI and decreased ionized calcium level, in developing of seroma.
We showed that Seroma formation was lower during thyroidectomy via electrical vessel sealing system in comparison with previous studies. In our study, older age, greater body mass index and decreased ionized calcium level were predictors of seroma formation.
血清肿被定义为术后手术部位的液体聚集,会引发多种并发症。识别易感风险因素有助于避免甲状腺切除术后血清肿的形成。
在3年期间开展了一项横断面研究,678例患者纳入该研究。我们记录了所有患者的人口统计学数据、既往病史和甲状腺切除术类型。在所有患者手术前及术后一天测量其血清总钙、离子钙和白蛋白水平。所有患者均接受全甲状腺切除术或次全甲状腺切除术,必要时随后进行中央区颈部淋巴结清扫。如果患者形成血清肿,则进行系列抽吸。
甲状腺切除术后血清肿的总体发生率为2.2%。在评估性别、年龄和体重指数与术后血清肿形成之间的关系时,未发现统计学上的显著相关性。然而,接受全甲状腺切除术的患者血清肿形成率显著更高(P = 0.041)。术后实验室检查结果显示,血清肿形成患者的离子钙水平显著更低(P < 0.0001)。逻辑回归显示,年龄、体重指数和离子钙水平降低等变量在血清肿形成方面具有统计学上的显著意义。
我们发现,与既往研究相比,通过血管电凝系统进行甲状腺切除术时血清肿形成率更低。在我们的研究中,年龄较大、体重指数较高和离子钙水平降低是血清肿形成的预测因素。