Drainage in uncomplicated thyroid and parathyroid surgery

Kristoffersson, Anders; Sandzén, Birger; Järhult, Johannes

doi:10.1002/bjs.1800730215

Cited by 54 publications

(55 citation statements)

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“…The fact that wound infections developed in two of our patients in the drained group, supports the belief that drains predispose the area to infective complications (Ariyanayagam et al, 1993;Kristoffersson et al, 1986;Tabaqchali et al, 1999).…”

Section: Resultssupporting

confidence: 83%

“…On the other hand, drain usage might be rejected in non-complicated cases because drainage is very low and might be not necessary, or because adequate haemostasis can never be replaceable by using drains; and in the case of incomplete drainage, seroma or hematoma would be the unavoidable conclusion (Karayacin et al, 1997;Peix et al, 1992;Ruark and Abdel-Misih, 1992). Or drains might be associated with possible infection (Ariyanayagam et al, 1993;Kristoffersson et al, 1986;Teboul et al, 1992). In addition, surgical techniques for benign thyroidal disorders have improved greatly over the past several years and postoperative morbidity and mortality rates have further decreased.…”

Section: Resultsmentioning

confidence: 99%

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Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

Çolak

Akça

Türkmenoğlu

et al. 2008

J. Zhejiang Univ. Sci. B

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Abstract:Objective: This prospective randomized clinical trial was conducted to evaluate the necessity of drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. Methods: A total of 116 patients who underwent total thyroidectomy or lobectomy for benign thyroidal disorders were randomly allocated to be drained or not. Operative and postoperative outcomes including operating time, postoperative pain assessed by visual analogue scale (VAS), total amount of intramuscular analgesic administration, hospital stay, complications, necessity for re-operation and satisfaction of patients were all assessed. Results: The mean operating time was similar between two groups (the drained and non-drained groups). The mean VAS score was found to be significantly low in the non-drained group patients in postoperative day (POD) 0 and POD 1. The mean amount of intramuscular analgesic requirement was significantly less in the non-drained group. One case of hematoma, two cases of seroma and three cases of transient hypoparathyroidism occurred in the non-drained group, whereas one case of hematoma, two cases of seroma, two cases of wound infections and two cases of transient hypoparathyroidism occurred in the drained group. No patient needed re-operation for any complication. The mean hospital stay was significantly shorter and the satisfaction of patients was superior in the non-drained group. Conclusion: These findings suggest that postoperative complications cannot be prevented by using drains after total thyroidectomy or lobectomy for benign thyroid disorders. Furthermore, the use of drains may increase postoperative pain and the analgesic requirement, and prolong the hospital stay. In the light of these findings, the routine use of drains might not be necessary after thyroid surgery for benign disorders.

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Section: Resultssupporting

confidence: 83%

Section: Resultsmentioning

confidence: 99%

Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

Çolak

Akça

Türkmenoğlu

et al. 2008

J. Zhejiang Univ. Sci. B

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“…9,18 Few studies have observed infective complications with the use of drain, but we didn't find such associations with drain use in present study. 7,17,19 Author found decreased post-operative pain in group A (without drain) which has been already reported in previous few studies. 5,7 Because of reduced pain and less discomfort, author found decreased length of hospital stay in the non-drainage group without any morbidity.…”

Section: Discussionsupporting

confidence: 69%

“…11 Most of the studies in literature concluded that suction drain is not necessary for routine thyroid surgery and the similar result author have got in present study for hemithyroidectomy. 2,5,7,9,11,19 Hence author believe that hemithyroidectomies are also safe without drains and no added advantages in keeping drains in thyroid surgeries.…”

Section: Discussionmentioning

confidence: 97%

Hemithyroidectomy with or without use of drain a randomized prospective clinical study

2018

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Background: The practice of using the drain in thyroid surgery including hemithyroidectomy is common to avoid complications like a hematoma. The aim of this study is to evaluate the necessity of routine drainage in hemithyroidectomy.Methods: In this randomized prospective clinical study conducted in tertiary care government training hospital,60 patients who underwent hemithyroidectomy for various thyroid disorders were randomly allocated to either non-drainage (group A) or drainage (group B). The various complications including hematoma, seroma, wound infection, post-operative pain, the length of hospital stay was then compared.Results: Both groups were comparable according to age, gender, thyroid size and histopathological diagnosis. A total number of 60 patients evaluated among them 45 females (75%) and 15 males (25%) were there. No significant difference in complications was observed between two groups regarding hematoma, wound infection, but the length of hospital stay was significantly reduced in the non-drainage group compared to drainage group (p-0.004), along with the significant reduction in post-operative pain (p-0.001).Conclusions: In present study, author observed that there is a significant reduction in length of hospital stay and post-operative pain in non-drainage group compared to drainage group. So suction drainage should be done in selected patients rather than a routine procedure and it is safe without suction drain especially in hands of experienced surgeons.

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“…These studies, however, are prone to bias because of their retrospective or nonrandomized comparative design. Some randomized controlled trials were performed to solve this difficulty [6,26,27,28,29,30,31,32,33,34,35,36,37]. None of them were able to demonstrate statistically significant differences in the frequency of acute or late neck hematoma/seroma.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Surgery: To Drain or Not to Drain, That Is the Problem - A Randomized Clinical Trial

Schietroma

Pessia

Bianchi

et al. 2017

ORL

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Purpose: We conducted a prospective, randomized study to evaluate the necessity of drainage after thyroid surgery. Methods: The patients (n = 215) were randomly assigned to be treated with suction drains (group 1; n = 108) or not (group 2; n = 107). Results: The postoperative pain scores were significantly lower in the non-drained group than in the drained group of patients at postoperative days 0 and at 1. Hematomas, seromas, wound infections, transient biochemical hypoparathyroidism, and transient damage of the recurrent laryngeal nerve occurred more frequently in the drained group than in the non-drained group. The mean hospital stay was significantly shorter in the non-drained group than in the drained group. Conclusions: Routine drain emplacement after thyroidectomy is unnecessary.

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Drainage in uncomplicated thyroid and parathyroid surgery

Cited by 54 publications

References 1 publication

Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

Hemithyroidectomy with or without use of drain a randomized prospective clinical study

Thyroid Surgery: To Drain or Not to Drain, That Is the Problem - A Randomized Clinical Trial

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