Objective: Bleeding is one of the most dangerous complications following thyroid and parathyroid surgery. For this reason prophylactic perioperative thromboprophylaxis is not routinely use. The aim of this study is to investigate the incidence of clinical and subclinical deep vein thrombosis (DVT) and to validate the Caprini score as a predictive factor of high risk patients after these operations.
Material and method: This is a prospective study involving patients who have undergone thyroid and parathyroid operations in our department. Preoperatively D-dimers level and ultrasonography of the lower extremity veins were used to exclude the pre-operative presence of DVT. Patients were scored using the Caprini criteria. None of them received thromboprophylaxis. Postoperatively, they were clinically evaluated for the presence of DVT, in addition to D-dimers level and color Doppler on the 7th post-operative day. The incidence of clinical and subclinical DVT was recorded.
Results: Data included 103 patients 1778 years (average 53.3) and body mass index 1648 (average 26.8). 94% of the patients were at higher and highest risk of developing DVT according to Caprini and should have received thromboprophylaxis. The mean D-dimers concentration was 1.1±0.8, while no patient developed clinical DVT postoperatively and had no subclinical DVT findings in the Doppler ultrasound the 7th post-operative day.
Conclusions: The risk of thromboembolic disease in patients undergoing thyroid and parathyroid operation cannot be reliably assessed with the Caprini system. Despite the risk factors, rapid post-operative mobilization of patients leads to the near zero incidence of DVT and therefore it seems that perioperative anticoagulation treatment is not necessary, possibly increasing the possibility of post-operative bleeding.