Zanco Journal of Medical Sciences
 
Skip Navigation Links
Home
Available Issues
Search
Editorial Board
Information for Authors
Review Process
Copyright
Links and Contacts
  Zanko J Med Sci:  Dec. 2016; 20 (3): 1419-1423

The routine insertion of drains after total thyroidectomy by harmonic scalpel, is it always necessary?



Abstract

Background and objective: Routine use of drains after thyroidectomy is not evidence based; nevertheless most surgeons use drains to alert them to the presence of postoperative bleeding and for the prevention of hematoma and seroma. This comparative study was conducted to evaluate the necessity of routine drainage after total thyroidectomy.

Methods: A total of 150 patients who underwent total thyroidectomy due to different indications at different hospitals in Erbil city, Iraq from June 2011 to December 2015, were included. A retrospective comparison was made between those drained (group 1) and those without drain (group 2). Operating time, postoperative complications and hospital stay were assessed.

Results: Operation time was significantly less in group 2 compared to group 1; 64.9 ± 7.64 minutes versus 73.8 ± 9.81 minutes, respectively. There was no statistically significant difference in the incidence of postoperative complications. Only two patients, both from group 1, developed a postoperative hematoma. Wound infection occurred only in 2 patients in group 1. Hospital stay was significantly shorter in group 2 compared to group 1; 21.1 ± 3.98 hours versus 41.7 ± 8.64 hours, respectively.

Conclusion: The routine use of drain is not necessary after total thyroidectomy; it increases the hospital stay and may increase the rate of postoperative sepsis.

Keywords: Drain; Thyroidectomy; Harmonic scalpel; Complications.


Reference

1. Chalya PL, Gilyoma JM, Mchembe M. Drain versus No Drain after Thyroidectomy : A prospective Randomized Clinical Study. East and Central African J Surg 2015; 0:11–3.

2. Ozlem N, Ozdogan M, Gurer A, Gomceli I, Aydin R. Should the thyroid bed be drained after thyroidectomy? Langenbecks Arch Surg 2006; 391(3):228–30.

3. Apalidis KS, Trati TS, Nastasiadis I a, Anteli NP, Iavas LL, Esisoglou IK, et al. Case Report Total thyroidectomy without the use of drainage - case series of 66 patients. Curernt Heal Sci J 2013; 40:2013–4.

4. Tabaqchali MA, Hanson JM, Proud G. Drains for thyroidectomy / parathyroidectomy: fact or fiction ? Ann R Coll Surg Engl 1999; 81:302–5.

5. Gooda MR, Oonwala ZG, Khan S. Use of Drainage after thyroid surgery: is it evidence based? Pakist J Surg 2007; 23(3):3–6.

6. Memon Z , Ahmed G, Khan SR, Khalid M, Sultan N. Postoperative use of drain in thyroid lobectomy -- a randomized clinical trial conducted at civil hospital, Karachi, Pakistan. Thyroid Research 2012; 5(1):9.

7. Koutsoumanis K, Koutras AS, Drimousis PG, Stamou KM, Theodorou D, Katsaragakis S, et al. The use of a harmonic scalpel in thyroid surgery: report of a 3-year experience. Am J Surg 2007; 193(6):693–6.

8. Pardal-Refoyo JL. Hemostatic Systems in Thyroid Surgery and Complications. Acta Otorrinolaringol 2011; 62(5):339–46.

9. 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.

10. Alamani J, Reala E, Castaneda S, Chua A. Drain versus No Drain After Thyroidectomy : A Preliminary Prospective Randomized Controlled Trial. Philipp J Otolaryngol Head Neck Surg 2014; 29(1):11-5.

11. The Routine Use of Post-Operative Drains in Thyroid Surgery : An Outdated Concept The Routine Use of Post-Operative Drains in Thyroid Surgery : An Outdated Concept. Ir Med J 2010; 103(1):26–7.

12. Key J. Thyroid surgery without drainage: 15 years of clinical experience. J R Coll Surg Edinb 1993; 38(4):69–70.

13. 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.

14. Khanna 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. BMC Surg 2005; 5(1):11.

15. Cernea CR, Brandão LG, Hojaij FC, De Carlucci D, Montenegro FLM, Plopper C, et al. How to minimize complications in thyroid surgery? Auris Nasus Larynx 2010 ; 37(1):1–5.

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

17. Lee SW, Choi EC, Lee YM, Lee JY, Kim SC. Is Lack of Placement of Drains After Thyroidectomy With Central Neck Dissection Safe ? A Prospective , Randomized Study. Laryngoscope 2006; 116(10):1632-5.

18. 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.

19. Colak T, Akca T, Turkmenoglu O, Canbaz H. Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. J Zhejiang Univ 2008; 9(4):319–23.

20. Giddings AE. The history of thyroidectomy. J R Soc Med 1998; 91(Suppl 3):3–6.

21. Bliss RD, Gauger PG, Delbridge LW. Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg 2000; 24(8):891-7.

22. Hannan SA. The magnificent seven: a history of modern thyroid surgery. Int J Surg 2006; 4(3): 187–91.

23. 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.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.