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Drains in thyroid and parathyroid surgery. Are they necessary?
M K Wax1, A P Valiulis, M K Hurst
1Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, USA.
Archives of Otolaryngology--Head & Neck Surgery
|September 1, 1995
Summary
Routine surgical drains may be unnecessary for select patients undergoing thyroid or parathyroid surgery. This study found low complication rates without drains, suggesting selective use is appropriate.
Area of Science:
- Endocrinology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Postoperative drainage is a common practice after thyroid and parathyroid surgery.
- The necessity and impact of prophylactic drains in specific patient groups remain debated.
Purpose of the Study:
- To evaluate the incidence of postoperative complications in patients undergoing elective thyroid or parathyroid surgery managed without surgical drains.
- To determine if routine drainage is essential for uncomplicated procedures in select patients.
Main Methods:
- Prospective evaluation of patients over a 6-year period at a community and tertiary referral center.
- Inclusion criteria focused on elective thyroid (57 patients) and parathyroid (8 patients) surgeries.
- Exclusion of 24 patients due to drain placement for reasons like large dead space or substernal goiter.
Main Results:
- Major complications were rare, including one hematoma requiring reoperation and one recurrent laryngeal nerve palsy.
- Minor complications included temporary hypocalcemia (3 patients), seroma (1 patient), and superior flap edema (20 patients) that resolved within 3 months.
Conclusions:
- Routine prophylactic drainage is not necessary for select patients undergoing uncomplicated thyroid or parathyroid surgery.
- Selective use of drains based on specific surgical factors can be considered, potentially reducing patient morbidity and resource utilization.