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The application of drains in thyroid surgery.
Mattia Portinari1,2, Paolo Carcoforo1,2
1Department of Surgery, Surgery, and Experimental Medicine, S. Anna University Hospital and University of Ferrara, Ferrara, Italy.
Gland Surgery
|November 17, 2017
Summary
Drains in thyroid surgery do not reduce reoperation rates for bleeding or complications like hematoma and seroma. However, using drains increases postoperative pain and hospital length of stay (LOS), with a potential rise in wound infections.
Area of Science:
- Surgical Oncology
- General Surgery
- Evidence-Based Medicine
Background:
- The utility of surgical drains following thyroidectomy remains debated.
- Previous studies suggest drains do not impact reoperation rates for hemorrhage.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) on drain use in thyroid surgery.
- To evaluate the impact of drains on postoperative complications, pain, and hospital length of stay (LOS).
Main Methods:
- Systematic search of PubMed and Embase databases for relevant RCTs.
- Included 20 RCTs with 2,204 patients comparing thyroidectomy with or without drains.
- Analyzed reoperation rates, hematoma, seroma, wound infection, pain (VAS), and LOS.
Main Results:
- No significant difference in reoperation rates, hematoma, or seroma formation between drained and undrained groups.
- Drained patients reported significantly higher postoperative pain (MD 1.91) and prolonged hospital LOS (MD 1.34 days).
- A trend towards increased wound infection in drained patients was observed, though not consistently confirmed.
Conclusions:
- Surgical drains in thyroid surgery do not reduce reoperation rates or major complications.
- Drain use is associated with increased postoperative pain and extended hospital LOS.
- Further large-scale RCTs are needed to confirm the correlation with wound infection rates.
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