Safety of thyroidectomy and cervical neck dissection without drains (original) (raw)
Related papers
Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders
Journal of Zhejiang University SCIENCE B, 2008
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.
BMC surgery, 2005
Drains are usually left after thyroid surgery to prevent formation of hematoma and seroma in the thyroid bed. This is done to reduce complications and hospital stay. Objective evaluation of the amount collected in the thyroid bed by ultrasonography (USG) can help in assessing the role of drains. A randomized prospective control study was conducted on 94 patients undergoing 102 thyroid surgeries, over a period of fifteen months. Patients included in the study were randomly allocated to drain and non-drain group on the basis of computer generated random number table. The surgeon was informed of the group just before the closure of the wound Postoperatively USG neck was done on first and seventh postoperative day by the same ultrasonologist each time. Any swelling, change in voice, tetany and tingling sensation were also recorded. The data was analyzed using two-sample t-test for calculating unequal variance. Both groups were evenly balanced according to age, sex, and size of tumor, ty...
Thyroid surgery complication comparison with or without drains application
Jentashapir Journal of Health Research, 2013
Background:Despite numerous reports that it is not necessary to use drains after thyroidectomy, the drains are still used routinely. The study aim to compare thyroid surgery complications with and without drains appliance. Materials and methods: A prospective study was conducted, 66 patients who were candidate for thyroid surgery (total-subtotal thyroidectomy and thyroid lobectomy) divided into 2 groups. Each group was randomized into "drain" and "non drain" subgroup. Some indicators were investigated such as primary thyroid size, fluid collection in thyroid bed (early and late), hospital stay, change in voice, dysphagia, wound infection, hematoma, seroma, and change in plasma calcium level. Statistical analyses were performed using chi-square test and Student's T test. Results: Duration of hospitalization in the patients without drains and received drain group were 2.3 and 3 days, respectively (p<0.02) There was not a significant difference between two groups (p>0.05) of fluid collection in thyroid bed and the incidence of other complications after surgery Conclusion: Routine use drains usage after thyroid surgery may not be necessary. However thyroidectomy without drains may be safe and effective method.
Is the Insertion of Drains After Uncomplicated Thyroid Surgery Always Necessary
Surgery Today, 2006
Purpose We conducted a prospective, randomized study to evaluate the necessity of drainage after uncomplicated thyroid surgery. Methods The subjects were 135 patients who underwent thyroid surgery between September 2002 and February 2004. The patients were randomized into two groups according to whether drains were inserted at the time of surgery. Group 1 consisted of 68 patients with drains and group 2 consisted of 67 patients without drains. The indications for surgery, procedures performed, local complications (such as infection, seroma, and bleeding or hematoma), necessity for reoperation, and hospital stay were recorded. Results There were 110 (81.5%) women and 25 (18.5%) men, with a median age of 46.9 ± 12.5 years. The mean hospital stay was 2.6 ± 1.0 days in group 1 and 1.3 ± 0.7 days in group 2 (P = 0.001). Local complications developed in five (7.3%) patients from group 1, as wound infections in two (2.9%), seroma in one (1.5%), and hemorrhage in two (2.9%); and in two (3%) patients from group 2, as seroma in one (1.5%) and hematoma in one (1.5%). Both of the group 1 patients with postoperative hemorrhage required reoperation within 8 h after initial surgery. The hematoma in the group 2 patient was treated successfully with needle aspiration. Conclusion These findings suggest that the routine use of drains may be abandoned in uncomplicated thyroid surgery, since serious postoperative bleeding rarely occurs and hematomas can be treated by needle aspiration if drains have not been placed. Furthermore, the use of drains prolongs hospital stay and increases the risk of infection.
Outcome of Thyroid Surgery without Drainage Tube- A Study of 60 Cases
Journal of Armed Forces Medical College, Bangladesh
Introduction: The use of a negative suction drainage tube in the neck in thyroid surgery is a common practice in order to avoid hematoma or seroma or other complication. It is associated with neck discomfort, post operative neck pain, delayed ambulation, longer hospital stay and ugly scar formation. Objective: To determine the advantages and safety of thyroid surgery without negative suction drainage tube. Materials and Methods: A cross-sectional observational study was carried out from September 2015 to May 2017 in the Department of Otolaryngology and Head-Neck Surgery, Kurmitola General Hospital, Dhaka Cantonment and Azmol and Life Aid General Hospital, Mirpur, Dhaka. A total of 60 patients who had undergone total thyroidectomy or hemithyroidectomy for thyroid disorders without drainage tube were included in this study. Patients with previous thyroid surgery, retrosternal goiter or malignant diseases of thyroid requiring neck dissection, undifferentiated thyroid cancer patients an...
Randomized Clinical Trial for Comparison of Drain Versus no Drain Thyroidectomy
Pakistan Journal of Medical and Health Sciences
Drains have been traditionally used routinely after thyroidectomy despite limited evidence to suggest any benefit. In many facilities, drains are routinely inserted after thyroidectomy with the aim of preventing hematoma formation and accumulation of seroma. Objective: To compare the outcome of drain versus no drain after thyroidectomy in patients presenting with clinically benign lesions of thyroid Methods: Study design is Randomized control trail. Settings are Department of Surgery, Mayo University Hospital Ireland. Study was completed in 6 months after the approval of synopsis 13-07-2015 to 31-05-2016. After taking approval from Hospital Ethical Committee, 60 patients fulfilling the inclusion criteria were selected from ward of Department of Surgery, Mayo University Hospital Ireland. Informed consent was taken. The demographic information was obtained. Patients were randomly divided in two groups by using lottery method. In group A, drain was inserted after surgery while in group...
Efficacy of Drainless Total Thyroidectomy in Intrathyroidal Lesions of Thyroid
International archives of otorhinolaryngology, 2018
There is difference of opinion about the placement of the drain in thyroid surgeries, and, to the best of our knowledge, the efficacy of drainless total thyroidectomy regarding various parameters of thyroid lesions has not been well-established. To report our experience with drainless total thyroidectomy, and to define an appropriate patient population for its performance. This is a retrospective case analysis of the patients who underwent total thyroidectomy for intrathyroidal lesions with or without central neck dissection in a tertiary referral hospital (number = 74). The patients, who had undergone total thyroidectomy without any drain insertion, were analyzed, and the relationships among various parameters of thyroid lesions were noted in relation to seroma and hematoma formation. Seroma formation was noted only in 5 out of 74 patents (6.75%). All of the seromas that occurred were observed in patients with thyroid lesions < 4 cm, and 4 out of 5 seromas were observed in p...
Assessment of the Morbidity and Complications of Total Thyroidectomy
Archives of Otolaryngology-head & Neck Surgery, 2002
Cross-sectional analysis of a national database on total thyroidectomy cases. Methods: The National Hospital Data Survey database was examined and all cases of total thyroidectomy performed during 1995 to 1999 were extracted. In addition to demographic information, postoperative complications including hypocalcemia, recurrent laryngeal nerve paralysis, wound complications, and medical morbidities were identified. Statistical analysis was conducted to determine potential predictive factors for postoperative complications. Results: A total of 517 patients were identified (mean age, 48.3 years). The most common indications for total thyroidectomy were thyroid malignancy and goiter (73.9% of cases). Eighty-one patients (15.7%) underwent an associated nodal dissection along with total thyroid-ectomy, and 16 patients (3.1%) underwent parathyroid reimplantation. The mean length of stay was 2.5 days (95% confidence interval, 2.3-2.8 days). The incidence of postoperative wound hematoma was 1.0%, wound infection was 0.2%, and mortality rate was 0.2%. The incidence of postoperative hypocalcemia was 6.2%. Younger age was statistically associated with an increased incidence of hypocalcemia (P=.002, t test), whereas sex (P=.48), indication for surgery (P=.32), parathyroid reimplantation (PϾ.99), and associated neck dissection (P=.21) were not. The mean length of stay was 2.5 days and was unaffected by occurrence of postoperative hypocalcemia. The incidences of unilateral and bilateral vocal cord paralyses were 0.77% and 0.39%, respectively. Conclusions: Postoperative hypocalcemia is the most common immediate surgical complication of total thyroidectomy. Other complications, including recurrent laryngeal nerve paralysis, can be expected at rates approximating 1%.