Drainage During Endoscopic Thyroidectomy

Abstract

Background:Conventional cervical drainage tubes are placed crossing the suprasternal fossa during endoscopic thyroidectomy. In our clinical experience, some patients show shallow or absent suprasternal fossa, which affects the cosmetic outcome in the patient. Therefore, this study aimed to assess the feasibility and significance of restoring the suprasternal fossa by changing the position of neck drainage tubes.Methods and Materials:A total of 117 female patients were enrolled and divided into 2 groups, including 59 and 58 individuals in the Conventional (conventional anterior neck region negative pressure drainage) and Improvement (improved method with a negative pressure drainage) groups. Then, restoration of the suprasternal fossa in all subjects was observed at 1 day postsurgery, the day of extubation, and 3 months postoperatively. In addition, drainage volume, the time to extubation, and abnormal neck sensations were compared between the groups.Results:Compared with the Conventional group, the Improvement group showed improved restoration of the suprasternal fossa, with the patients more satisfied with the cosmetic outcome. However, operation time, postoperative drainage volume, and extubation time were not significantly different between the 2 groups.Conclusions:In endoscopic thyroidectomy via the chest and breast approach, using the new drainage technique described here could yield improved restoration of the suprasternal fossa, ameliorating the cosmetic outcome and patient satisfaction.

Drainage Tube Placement May Not Be Necessary During Endoscopic Thyroidectomy Bilateral Areola Approach: A Preliminary Report

“…In the drain group, the postoperative drainage time was 1.16 ± 0.46 days and the postoperative total drainage volume was 65.67 ± 39. 26 (1.16 ± 0.81), P = 0.090]. Five patients in the drain group took temporary pain medication after surgery, while the number in the no-drain group was one.…”

“…Most patients removed drainage tubes on the first postoperative day and were discharged 2 days after surgery, which was significantly shorter than previous literature. Wang et al ( 14 ) and Chen et al ( 26 ) reported the drainage time with 2.7 ± 0.6 days and 4.3 ± 0.9 days, respectively, and the hospital stay with 6.4 ± 1.2 days and 6.4 ± 0.8 days, respectively. Previous studies revealed that drain placement is associated with more extended hospital stay in COT ( 9 – 12 ), and the application of negative pressure drainage is an important reason that interferes with lymph tube sealing and increases drainage volume ( 31 ).…”

“…And the utilization of the special visual separation bar and trocar can help better control intraoperative hemorrhage ( 15 ). Chen et al changed the position of the drainage tube in order to achieve better cosmetic outcomes ( 26 ). In this study, we abandoned the use of drainage directly, reporting no severe postoperative complications.…”