Evaluation of a Continuous High Negative Pressure Suction Device in Treating Postoperative Thyroid Bleeding: A Retrospective Cohort Study

Background Postoperative hemorrhage, 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 (CHNPD) in the management of suspected postoperative bleeding and its impact on decreasing the incidence of urgent reoperations. Methods 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 negative pressure drainage group (NPD, n = 45) and the continuous high negative pressure drainage group (CHNPD, 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). Results The baseline characteristics of the two groups were comparable (P > 0.05). The reoperation rate in the CHNPD group was significantly lower than that in the NPD group (11.1% vs. 26.7%; P = 0.023). Subgroup analysis indicated that CHNPD was particularly effective in malignant cases involving lymph node dissection, reducing the reoperation rate from 32.0% to 9.4%. During reoperation, it was observed that the NPD group experienced a higher incidence of "diffuse bleeding" due to the failure of conservative treatment, necessitating surgical intervention. In contrast, CHNPD effectively managed such bleeding, enabling surgical exploration to concentrate more precisely on the specific arterial bleeding points. No complications associated with high-pressure suction were reported. Conclusion The prompt implementation of Closed Hemostatic Negative Pressure Drainage (CHNPD) following thyroid surgery for suspected hemorrhage constitutes a safe and cost-effective intervention. By ensuring unobstructed drainage and mitigating hematoma tension, CHNPD 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.