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European Archives of Oto-Rhino-Laryngology

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Open Access 16-03-2022 | Hematoma | Review Article

Risk of hematoma after hemithyroidectomy in an outpatient setting: a systematic review and meta-analysis

Authors: Karin Jeppesen, Caroline Moos, Tórhild Holm, Andreas Kristian Pedersen, Helene Skjøt-Arkil

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2022

Abstract

Purpose

After thyroid surgery, the overriding concern is the risk of post-thyroid bleeding (PTB). This systematic review and meta-analysis aimed to assess the safety of hemithyroidectomy in an outpatient setting compared to an inpatient setting. The objectives were to (1) find the proportion of PTB in patients scheduled for outpatient hemithyroidectomy, (2) examine if outpatient hemithyroidectomy is clinically safe compared to an inpatient setting and (3) evaluate which selection criteria are most relevant for hemithyroidectomy in an outpatient setting.

Methods

A systematic review was conducted using the following databases: MEDLINE (Ovid), EMBASE (Ovid) and the Cochrane Library from inception until September 2021. We included studies reporting on PTB of patients after hemithyroidectomy in an outpatient setting. The risk of bias was assessed using the Newcastle-Ottawa tool. The results were synthesised using Bayesian meta-analysis. Certainty in evidence was assessed using the GRADE approach.

Results

This review included 11 cohort studies and 9 descriptive studies reporting solely on outpatients resulting in a total of 46,866 patients. PTB was experienced by 58 of the 9025 outpatients (0.6%) and 415 of the 37,841 inpatients (1.1%). There was no difference between the PTB rate of outpatients and inpatients (RR 0.715 CrI [0.396–1.243]). The certainty of the evidence was very low due to the high risk of bias.

Conclusion

The risk of PTB in an outpatient setting is very low, and outpatient hemithyroidectomy should be considered clinically safe. The most relevant selection criteria to consider in outpatient hemithyroidectomy are (1) relevant comorbidities and (2) psycho/-social factors.

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Title: Risk of hematoma after hemithyroidectomy in an outpatient setting: a systematic review and meta-analysis
Authors: Karin Jeppesen
Caroline Moos
Tórhild Holm
Andreas Kristian Pedersen
Helene Skjøt-Arkil
Publication date: 16-03-2022
Publisher: Springer Berlin Heidelberg
Keywords: Hematoma
Hemithyroidectomy
Thyroidectomy
Hemithyroidectomy
Thyroidectomy
Published in: European Archives of Oto-Rhino-Laryngology / Issue 8/2022
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-022-07312-y

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Springer Medicine

Risk of hematoma after hemithyroidectomy in an outpatient setting: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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