Is routine drainage after total thyroidectomy necessary?
Article Type: Letter to the editor
Subject: Thyroidectomy (Physiological aspects)
Drainage, Surgical (Physiological aspects)
Drainage, Surgical (Management)
Author: Sozen, Selim
Pub Date: 11/01/2011
Publication: Name: South African Journal of Surgery Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 South African Medical Association ISSN: 0038-2361
Issue: Date: Nov, 2011 Source Volume: 49 Source Issue: 4
Topic: Event Code: 200 Management dynamics Computer Subject: Company business management
Geographic: Geographic Scope: South Africa Geographic Code: 6SOUT South Africa
Accession Number: 280557387
Full Text: To the Editor: Most surgeons follow the practice of leaving a drain following thyroid surgery, in the hope that this will obliterate the dead space and evacuate collected blood and serum. The main reason is to drain off a possible post-operative haemorrhage that may compress air passages and produce respiratory failure. Although haemorrhage after thyroid surgery is rare, it may be life-threatening and require immediate re-operation. (1,2) According to Karayacin et al., routine drainage after thyroid surgery is not necessary, and a selective policy can be safely applied. (3) A total of 100 patients who underwent total thyroidectomy for benign thyroidal disorders were randomly allocated to be drained or not. The drained group comprised 2 men and 48 women. The non-drained group comprised 10 men and 40 women. There was no significant difference in the gender, age, hormonal status and histopathological results between the patients of the two groups (p=0.18, p=0.36, p=0.28 and p=0.40, respectively). The complication rate was similar between the two groups. One case of haematoma (2%), 2 cases of seroma (4%) and 3 cases of transient hypoparathyroidism (6%) occurred in the non drained group; 1 case of haematoma (2%), 2 cases of seroma (4%), 2 cases of wound infection (4%) and 2 cases of transient hypoparathyroidism (4%) occurred in the drained group (p=0.69). Routine drainage of the thyroid bed following thyroid surgery may not be necessary.

Selim Sozen

Elazig Training and Research Hospital

Elazig

Turkey

(1.) Ardito G, Revelli L, Guidi ML, et al. Drainage in thyroid surgery. Ann Ital Chir 1999;70(4):511-516.

(2.) Daou R. Thyroidectomy without drainage. Chirurgie 1997;122(7): 408-410.

(3.) Karayacin K, Besim H, Ercan F, Hamamci O, Korkmaz A. Thyroidectomy with and without drains. East Afr Med J 1997;74(7):431-432.
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