Evaluation of a continuous high negative pressure suction device in treating postoperative thyroid bleeding: a retrospective cohort study

Postoperative hemorrhage(POH), although infrequent, represents a potentially life-threatening complication subsequent to thyroidectomy, frequently leading to acute airway obstruction. Conventional negative pressure drainage (NPD) systems may prove inadequate in instances of rapid hemorrhage due to catheter occlusion by thrombi. This study assessed the effectiveness of a continuous high negative pressure suction device (CHNPSD) in the management of suspected postoperative bleeding and its impact on decreasing the incidence of urgent reoperations. A retrospective analysis was performed on a cohort of 5,251 patients who underwent thyroid surgery between 2015 and 2024. Of these, 126 patients exhibiting clinical indicators of postoperative hemorrhage, such as a sudden increase in drainage volume or neck swelling, were selected for further study. Based on the intervention strategies employed at the time of hemorrhage occurrence, patients were categorized into two groups: the conventional NPD group ( n = 45) and the continuous high negative pressure suction device group (CHNPSD, n = 81). The primary outcome measure was the rate of emergency reoperation. Additionally, subgroup analyses were conducted according to pathological type (benign versus malignant) and surgical approach (laparoscopic versus open). The baseline characteristics of the two groups were comparable ( P > 0.05). The reoperation rate in the CHNPSD group was significantly lower than that in the NPD group (11.1% vs. 26.7%; OR 0.34,95% CI: 0.13–0.91; P = 0.023). Multivariable logistic regression analysis confirmed that CHNPSD was associated with a 68% reduction in the odds of emergency reoperation compared with NPD (OR 0.32, 95% CI: 0.12–0.85; P = 0.021) after adjusting for pathological malignancy and surgical extent. Subgroup analysis indicated that CHNPSD was particularly effective in malignant cases, reducing the reoperation rate from 37.0% to 9.4% ( P = 0.007).No complications associated with high-pressure suction were reported. The use of a continuous high negative pressure suction device (CHNPSD) is a safe and cost-effective intervention when bleeding is suspected after thyroid surgery.By ensuring unobstructed drainage and mitigating hematoma tension, CHNPSD substantially decreases the incidence of unnecessary re-exploratory surgeries, particularly in cases of diffuse venous or capillary bleeding. Nonetheless, clinicians must maintain vigilance regarding the potential occurrence of arterial bleeding.