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Rethinking drain protocols in pediatric thyroidectomy.

Kaitlyn Zenner1, Ashley L Soaper2, Charles M Myer2

  • 1Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, 3333 Burnett Ave, Cincinnati, OH, 45229, USA.

International Journal of Pediatric Otorhinolaryngology
|October 9, 2025
PubMed
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For pediatric thyroidectomy, drain use did not increase complication risks like hematoma, seroma, or infection. Omitting drains in pediatric thyroidectomies is safe and may not be necessary, especially with central neck dissection.

Area of Science:

  • Pediatric Surgery
  • Endocrine Surgery
  • Surgical Outcomes

Background:

  • Pediatric thyroidectomy is rare, with limited data on drain use complications.
  • Adult studies suggest drains may increase infection risk without reducing hematoma/seroma.
  • This study addresses drain use impact in pediatric thyroidectomy patients.

Purpose of the Study:

  • To determine if drain placement affects postoperative complication rates in pediatric thyroidectomy.
  • To analyze the relative risk of complications comparing drain versus no-drain groups.

Main Methods:

  • Retrospective case series of patients under 21 undergoing thyroidectomy (with/without neck dissection).
  • Data collected from July 2011 to October 2024 at a tertiary children's hospital.

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  • Primary outcome: relative risk of complication associated with drain use.

    • Main Results:

    • 310 procedures in 289 patients; drains used in 34.2% of total thyroidectomies without neck dissection.
    • No complications occurred with neck dissection, regardless of drain use.
    • Hematomas (1), infections (3), and seromas (1) were rare; drain use showed no clear association with increased risk.

    Conclusions:

    • Post-thyroidectomy complications are infrequent in children.
    • Forgoing drain placement did not elevate complication risk in this pediatric cohort.
    • Drains may not be essential for pediatric thyroidectomy, particularly when central neck dissection is performed.