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To drain or not to drain in thyroid surgery. A controlled clinical study
O Wihlborg1, L Bergljung, H Mårtensson
1Department of Surgery, Ljungby Hospital, Helsingborg, Sweden.
Archives of Surgery (Chicago, Ill. : 1960)
|January 1, 1988
Summary
Routine surgical drainage after thyroid surgery does not appear to prevent complications. This study found no significant difference in complication rates between patients with or without surgical drains.
Area of Science:
- Endocrinology
- Surgical Oncology
- General Surgery
Background:
- Surgical drainage is a common practice following thyroid surgery to manage potential complications.
- Evidence supporting the routine use of drains to prevent adverse outcomes remains limited.
Purpose of the Study:
- To prospectively evaluate the efficacy of surgical drainage in reducing complication rates after thyroid surgery.
- To compare outcomes between patients who underwent thyroidectomy with and without surgical drains.
Main Methods:
- A prospective, randomized study involving 150 patients undergoing thyroid surgery.
- Patients were randomized into two groups: one with surgical drainage and one without.
- Complication rates, including bleeding, nerve palsies, hypocalcemia, hematomas, infection, and lymphatic leakage, were meticulously recorded.
Main Results:
- No statistically significant difference in complication rates was observed between the drainage and no-drainage groups.
- Factors such as surgeon experience, operation type, diagnosis, specimen weight, operation time, and hospital stay did not influence the outcomes.
- Specific complications included reoperations for bleeding, permanent laryngeal nerve palsies, permanent hypocalcemia, minor hematomas, wound infection, and lymphatic leakage, with similar incidence in both groups.
Conclusions:
- Prophylactic routine surgical drainage is not supported for uncomplicated thyroid surgery based on this study's findings.
- The decision to use drains should be individualized, considering the potential benefits versus the lack of demonstrated efficacy in reducing complications.