CONTEMPORARY STRATEGIES FOR HEMOSTASIS AND PREVENTION OF POSTOPERATIVE COMPLICATIONS IN THYROID SURGERY

Thyroid surgery is one of the most common procedures in endocrine surgery, and its safety depends largely on preventing postoperative haemorrhage, recurrent laryngeal nerve injury and hypoparathyroidism. To analyse international and regional literature on measures to prevent complications and the effectiveness of haemostatic methods in thyroid surgery, including ligation, bipolar coagulation, energy-based devices, topical haemostatic agents and wound drainage. Postoperative bleeding is reported in approximately 1–2% of cases. Risk factors include older age, reoperation, retrosternal goitre, extent of thyroidectomy and surgeon experience. Meta-analyses have found no significant differences in key clinical outcomes between energy-based devices. Evidence on topical haemostatic agents is inconsistent and relates mainly to drain output and length of hospital stay. Routine drainage does not reduce bleeding risk and may increase the risk of infection. A single-centre regional study reported that the overall complication rate decreased from 29.5% to 10.2% when Hemoben was combined with low-level laser therapy; however, the findings were based on a historical control group. Reliable haemostasis, surgical technique and surgeon experience remain crucial. Multicentre randomised studies are needed to establish the effectiveness of newer local methods.