Drains after thyroid surgery

Main Article Content

Víctor Hernández-Avendaño
Maricela Jiménez-López

Keywords

Postoperative Complications, Thyroidectomy, Drainage

Abstract

Background: Thyroidectomy is one of the most common procedures and the most feared complication is the hematoma that obstructs the airway, which leads to the use of drains, although the evidence of the benefits of its use is limited.


Objective: To analyze the frequency of the use of drains, the type of surgery and hospital stay in patients undergoing thyroid surgery.


Method: We included patients with diverse thyroid diseases with and without drains. The information was gathered retrospectively, including the patient characteristics, the type of surgery and the histopathology result.


Results: Out of the 44 patients, only 9% used drainage and the most frequent diagnosis was papillary thyroid cancer. The most frequent procedure was right hemithyroidectomy; all patients with drainage had larger lesions, but no statistical difference was found between the groups (p = 0.174). Drains have been used for multiple reasons, although evidence shows it is unnecessary. In this study we observed that the patients with longer hospital stay were the cases of lesions that needed complex procedures, which can contribute to the use of drains.


Conclusions: The use of drains is controversial; it depends on the surgical education of the surgeon. In this study drains were used for procedures with bigger lesions, although there was no difference with patients with similar lesions without drains. The best way of avoiding the use of drains is to be careful and pay attention to details during surgery. 

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References

1. Kalemera Ssenyondo E, Fualal J, Jombwe J, Galukande M. To drain or not to drain after thyroid surgery:a randomized controlled trial at a tertiary Hospital in East Africa. Afr Health Sci. 2013;13(3):748-55.

2. Woods RSR, Woods JFC, Duignan ES, Timon C. Systematic review and meta-analysis of wound drains after thyroid surgery. Br J Surg. 2014;101(5):446-56.

3. Khana J, Mohil RS, Chintamani, Bhatnagar D, Mittal MK, Sahoo M, et al. Is the routine drainage after surgery for thyroid necessary?A prospective randomized clinical study [ISRCTN63623153]. BMC Surg. 2005;5:11.

4. Sapalidis K, Strati T, Anastasiadis I, Panteli N, Liavas L, Kesisoglou I, et al.Total thyroidectomy without the use of drainage —case series of 66 patients. CHSJ. 2014;40(1):60-1.

5. Pérez JA, Urrutia V, Silva P, Murúa A. Uso selectivo de drenajes en tiroidectomías. Rev Chil Cir. 2009;61(6):515-8.

6. Sanabria A, Carvalho A, Silver C, Rinaldo A, Shaha A, Kowalski L, et al.Routine drainage after thyroid surgery —a meta-analysis. J Surg Oncol. 2007;96(3):273-80.

7. Portinari M, Carcoforo P. The application of drains in thyroid surgery. Gland Surg. 2017;6(5):56373. doi:10.21037/gs.2017.07.04

8. Sánchez-Blanco JM. Uso de drenajes en cirugía tiroidea y paratiroidea. Cir Esp. 2004;75(6):319-25.

9. Tian J, Li L, Liu P, Wang X. Comparison of drain versus no-drain thyroidectomy:a meta-analysis. Eur Arch Otorhinolaryngol. 2017;274(1):567-77.

10. Schoretsanitis G, Melissas J, Sanidas E, Christodoulakis M, Vlachonikolis JG, Tsiftsis DD. Does draining the neck affect morbidity following thyroid surgery?Am Surg. 1998;64(8):778-80.

11. Hurtado-López LM, López-Romero S, Rizzo-Fuentes C, Zaldívar-Ramírez FR, Cervantes-Sánchez C. Selective use of drains in thyroid surgery. Head Neck. 2001;23(3):189-93.

12. Ishaq I, Iqbal J, Ajmal R, Afzal M, Munir K. The role of drainage after thyroid surgery. Is it mandatory?APMC. 2008;2(1):46-9.

13. Neary PM, O'Connor OJ, Shafiq A, Quinn EM, Kelly JJ, Juliette B, et al. The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery:a prospective randomised clinical trial. World J Surg Oncol. 2012;10:72.

14. Nawaz S, Naeem A, Zeb A. Thyroid surgery:drain versus no drain. J Postgrad Med Inst. 2015;29:101-4.

15. Suslu N, Vural S, Oncel M, Demirca B, Gezen FC, Tuzun B, et al. Is the insertion of drains after uncomplicated thyroid surgery always necessary?Surg Today. 2006;36(3):215-8.

16. Deveci U, Altintoprak F, Kapakli MS, Manukyan MN, Cubuk R, Yener N, et al. Is the use of a drain for thyroid surgery realistic?A prospective randomized interventional study. J Thyroid Res. 2013;2013:2ↀ8.

17. Corsten M, Johnson S, Alberabi A. Is suction drainage an effective means of preventing hematoma in thyroid surgery?A meta-analysis. J Otolaryngol. 2005;34(6):415-7.

18. Morrissey AT, Chau J, Yunker WK, Mechor B, Seikaly H, Harris JR. Comparison of drain versus no drain thyroidectomy:randomized prospective clinical trial. J Otolaryngol Head Neck Surg. 2008;37(1):43-7.

19. Herranz J, Latorre J. [Drainage in thyroid and parathyroid surgery]. Acta Otorrinolaringol Esp. 2007;58(1):7-9.

20. Lee SW, Choi EC, Lee YM, Lee JY, Kim SC, Koh YW. Is lack of placement of drains after thyroidectomy safe?Laryngoscope. 2006;116(9):1632-5.