Bleeding after neck endocrine operations

Bleeding after neck endocrine operations is rare but can be life-threatening complication and requires immediate surgical intervention. Retrospective 1726 patients' data operated from 2016-2020 were analysed. Bleeding with need of reoperation occurred in 24 (1.4%) of cases: 19/1368 (1.4%) after thyroid and 5/358 (1.4%) after parathyroid operations. Data were analysed regarding indications, type of surgery, time till reoperation, site of bleeding, comorbidities and outcome Indications for surgery: suspected or proven malignancy 9 (37.5%), compression symptoms 5 (20.8%), thyrotoxicosis 4 (16.6%), PHPT 4 (16.7%), SHPT and recurrent thyroid cyst 1 (4.2%) case each. Bleeding was more common in bilateral operations - 17 (70.8%) vs one side 7 (29.2%). Mean time till reoperation was 189 min (5-460), majority within first 4 hours - 16 (66.7%). More commonly bleeding site was noticed subcutaneously - 12 (50.0%) vs 9 (37.5%) in paratracheal space. In 3 (12.5%) patient site was not identified. Sixteen (66.7%) patients had anamnesis of arterial hypertension. Increased blood pressure during perioperative period was noticed in 21(87.5%) patients. Sixteen (66.7%) patients were discharged within 2 days after operation, 6 (25.0%) in 3-5 days, 1 on 10th day and 1 patient died on 8th postoperative day. Bleeding after cervicotomy can equally occurred after thyroid and parathyroid operations, with highest prevalence in both side operations. Bleeding more commonly occurred within first 4 hours. Patients with arterial hypertension are at higher risk for postoperative bleeding.