CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2018; 22(03): 256-259
DOI: 10.1055/s-0037-1606183
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Efficacy of Drainless Total Thyroidectomy in Intrathyroidal Lesions of Thyroid

Azhar Jan Battoo
1   Department of Surgical Oncology, Sher i Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
Altaf Gauhar Haji
1   Department of Surgical Oncology, Sher i Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
Zahoor Ahmad Sheikh
1   Department of Surgical Oncology, Sher i Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
Krishnakumar Thankappan
2   Department of Head and Neck Surgical Oncology, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
Wahid Abdul Mir
1   Department of Surgical Oncology, Sher i Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
› Institutsangaben
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06. April 2017

11. Juli 2017

25. Oktober 2017 (online)


Introduction There is difference of opinion about the placement of the drain in thyroid surgeries, and, to the best of our knowledge, the efficacy of drainless total thyroidectomy regarding various parameters of thyroid lesions has not been well-established.

Objective To report our experience with drainless total thyroidectomy, and to define an appropriate patient population for its performance.

Methods This is a retrospective case analysis of the patients who underwent total thyroidectomy for intrathyroidal lesions with or without central neck dissection in a tertiary referral hospital (number = 74). The patients, who had undergone total thyroidectomy without any drain insertion, were analyzed, and the relationships among various parameters of thyroid lesions were noted in relation to seroma and hematoma formation.

Results Seroma formation was noted only in 5 out of 74 patents (6.75%). All of the seromas that occurred were observed in patients with thyroid lesions < 4 cm, and 4 out of 5 seromas were observed in patients with a malignant pathology. There was no statistically significant difference in seroma formation between patients younger or older than 50 years of age.

The nature of the lesion, whether benign or malignant, did not affect the formation of seroma. Of interest is the fact that none of the 10 patients who had central neck dissection performed as part of their treatment developed seroma.

Conclusions Drainless total thyroidectomy is safe across all age groups for patients harboring either benign or malignant thyroid pathologies. However, caution is to be observed in opting for drainless total thyroidectomy in patients with large lesions (> 5 cm)

  • References

  • 1 Shaha AR, Jaffe BM. Practical management of post-thyroidectomy hematoma. J Surg Oncol 1994; 57 (04) 235-238
  • 2 Abbas G, Dubner S, Heller KS. Re-operation for bleeding after thyroidectomy and parathyroidectomy. Head Neck 2001; 23 (07) 544-546
  • 3 Woods RSR, Woods JFC, Duignan ES, Timon C. Systematic review and meta-analysis of wound drains after thyroid surgery. Br J Surg 2014; 101 (05) 446-456
  • 4 Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid 2009; 19 (11) 1159-1165
  • 5 Kristoffersson A, Sandzén B, Järhult J. Drainage in uncomplicated thyroid and parathyroid surgery. Br J Surg 1986; 73 (02) 121-122
  • 6 Wihlborg O, Bergljung L, Mårtensson H. To drain or not to drain in thyroid surgery. A controlled clinical study. Arch Surg 1988; 123 (01) 40-41
  • 7 Ariyanayagam DC, Naraynsingh V, Busby D, Sieunarine K, Raju G, Jankey N. Thyroid surgery without drainage: 15 years of clinical experience. J R Coll Surg Edinb 1993; 38 (02) 69-70
  • 8 Khanna J, Mohil RS. , Chintamani, et al. Is the routine drainage after surgery for thyroid necessary? A prospective randomized clinical study [ISRCTN63623153]. BMC Surg 2005; 5: 11
  • 9 Colak T, Akca T, Turkmenoglu O. , et al. Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. J Zhejiang Univ Sci B 2008; 9 (04) 319-323
  • 10 Neary PM, O'Connor OJ, Shafiq A. , et al. The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery: a prospective randomised clinical trial. World J Surg Oncol 2012; 10: 72
  • 11 Memon ZA, Ahmed G, Khan SR, Khalid M, Sultan N. Postoperative use of drain in thyroid lobectomy - a randomized clinical trial conducted at Civil Hospital, Karachi, Pakistan. Thyroid Res 2012; 5 (01) 9
  • 12 Deveci U, Altintoprak F, Sertan Kapakli M. , et al. Is the use of a drain for thyroid surgery realistic? A prospective randomized interventional study. J Thyroid Res 2013; 2013: 285768
  • 13 Papavramidis TS, Pliakos I, Michalopoulos N. , et al. Classic clamp-and-tie total thyroidectomy for large goiters in the modern era: To drain or not to drain. World J Otorhinolaryngol 2014; 4 (01) 1-5
  • 14 Conzo G, Mauriello C, Docimo G. , et al. Clinicopathological pattern of lymph node recurrence of papillary thyroid cancer. Implications for surgery. Int J Surg 2014; 12 (Suppl. 01) S194-S197