Redo thyroid surgery without drains

Abboud, Bassam; El-Kheir, Alaa

doi:10.1007/s00595-020-02065-9

Cited by 3 publications

(4 citation statements)

References 36 publications

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“…Nevertheless, these results are in accordance with the existing literature on the impact of drain use on postoperative hematoma in thyroidectomies. [5][6][7][8][9][10][11][12][13] In the present study, drain use was independently associated with prolonged length of stay. This is consistent among studies on cases of non-substernal goiter undergoing thyroidectomy.…”

Section: Discussionsupporting

confidence: 52%

“…Despite the evidence against drain placement after thyroidectomy, [5][6][7][8][9][10][11][12][13][14] there is a lack of consensus on drain use in patients with substernal goiter. This could be attributed to many comparative studies excluding cases with substernal goiter, as identified by a recent systematic review.…”

Section: Introductionmentioning

confidence: 99%

“…5 However, this has been declining as evidence has shown no significant impact of drain placement on the development of postoperative neck hematoma. [5][6][7][8][9][10][11][12][13] Contrarily, drain use has been associated with higher risks of other adverse outcomes. 5,7,14 Two recent meta-analyses 5,14 based on randomized controlled trials found that drain placement independently increased the likelihood of higher postoperative pain, prolonged hospital stay, and wound infections.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Drain Placement on Postoperative Complications after Thyroidectomy for Substernal Goiter

Waqar,

Hameed,

Angez

et al. 2024

Int Arch Otorhinolaryngol

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Introduction Despite the evidence against drain placement after thyroidectomy, there is a lack of consensus on drain use in patients with substernal goiter. Objective To assess the factors that increase the likelihood of drain placement and its impact on postoperative hematoma and other 30-day complications among adult patients undergoing thyroidectomy for substernal goiter. Methods A retrospective cohort study that used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Adult patients (aged ≥ 18 years) who underwent elective thyroidectomy for substernal goiter from 2016 to 2020 were included. Cases with closed suction neck drains placed upon completion of surgery were included in the drain group, and the remaining cases formed the nondrain group. Results A total of 1,229 patients were included (46.5% with drain placement). The factors that increased the likelihood of drain placement included body mass index (BMI) ≥ 30 kg/m2, score between 3 and 5 on the American Society of Anesthesiologists (ASA) physical status classification, sternal split/transthoracic surgical approach, operative time ≥ 90 minutes, and surgery conducted by otolaryngologists. Patients with clean-contaminated or contaminated wound classifications were less likely to be submitted to drain placement. In addition, drain use had no impact on postoperative hematoma formation but was found to independently increase the risk of prolonged length of hospital stay. Conclusion Thyroidectomy without drain placement might be safe for substernal goiter. However, this decision should be individualized for each patient.Level Of Evidence: 3

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Drain Placement on Postoperative Complications after Thyroidectomy for Substernal Goiter

Waqar,

Hameed,

Angez

et al. 2024

Int Arch Otorhinolaryngol

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“…A surgeon typically inserts drains to stop bleeding and detect it early after thyroid surgeries. However, drain implantation increases the risk of infection and lengthens the hospital stay ( 27 , 28 ). Patients are typically released from the hospital on the day of surgery because it is known that the risk of respiratory failure brought on by a haematoma is highest in the first six hours following thyroid surgery ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

The safety and efficacy of fibrin sealant for thyroidectomy: a systematic review and meta-analysis of randomized controlled trials

Koerniawan,

Candrawinata,

Tjahyanto

et al. 2023

Front. Surg.

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Fibrin sealants have recently been thoroughly studied in several surgical specialties; however, results are conflicting. We aimed to examine the safety and efficacy of fibrin sealant patients having thyroidectomies. A thorough, systematic literature search was carried out using the terms thyroidectomy and fibrin sealant using PubMed, Cochrane Library, and Clinicaltrials.gov on December 25, 2022. The primary outcome of interest in this review was the amount of drainage, whereas hospitalization, the length of drain retention, and temporary dysphonia were secondary outcomes. Our meta-analysis (n = 249) showed that application of fibrin sealant is associated with lesser total drainage [SMD −2.76 (−4.83, −0.69); P = 0.009; I2 97%], but not with retention time of drainage [SMD −2.35 (−4.71, 0.01); P = 0.05; I2 98%], hospitalization time [SMD −1.65 (−3.70, 0.41); P = 0.12; I2 97%], and transient dysphonia [RR 1.01 (0.27, 3.82); P = 0.99; I2 0%]. The systematic review found that the use of fibrin sealant in thyroid surgery is positive in total volume drainage but not with the retention time of drainage, hospitalization time, and transient dysphonia. It is notable to remember that this interpretation is complicated by uneven, occasionally subpar technique and trial reporting, according to this systematic review's findings.

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What are the real rates of temporary hypoparathyroidism following thyroidectomy? It is a matter of definition: a systematic review

et al. 2021

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Introduction Post-operative hypoparathyroidism is the most encountered complication of thyroid surgery and is classified as temporary or permanent. However, its incidence varies greatly in the literature ranging from 0.5% to 65%. This can be mainly attributed to the different definition of hypoparathyroidism used in each study and especially to the different time cutoff applied to distinguish temporary from permanent hypoparathyroidism. Methods We conducted a systematic literature search in PubMed, Scopus, Cochrane and GoogleScholar databases, as well as grey literature. Ultimately, 45 articles with 23,164 patients in total were included in this review. These articles used either the cutoff of six or twelve post-operative months to distinguish temporary from permanent hypoparathyroidism. Results The overall incidence of permanent hypoparathyroidism diagnosed at 6 months post-operatively was 4.11% and 4.08% at 12 months post-operatively. There was no statistically significant difference between the two groups (p = 0.92). Conclusions We suggest that adhering to the current guidelines that recommend diagnosing temporary hypoparathyroidism when recovery is made within 6 months after surgery is important when conducting future research in order to narrow the gap that exists currently in the literature, as well as when deciding to put patients on long-term calcium supplements.

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Redo thyroid surgery without drains

Cited by 3 publications

References 36 publications

Impact of Drain Placement on Postoperative Complications after Thyroidectomy for Substernal Goiter

Impact of Drain Placement on Postoperative Complications after Thyroidectomy for Substernal Goiter

The safety and efficacy of fibrin sealant for thyroidectomy: a systematic review and meta-analysis of randomized controlled trials

What are the real rates of temporary hypoparathyroidism following thyroidectomy? It is a matter of definition: a systematic review

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