Key result
The use of drains in thyroid surgery did not reduce hematomas, bleeding, or seromas, but significantly increased the risk of postoperative infection (OR 3.31) and prolonged hospital stays.
Why the study?
Thyroid surgery carries a risk of significant postoperative bleeding, prompting assessment of whether drains effectively prevent complications like hematomas, seromas, and bleeding, and how they affect infection rates and hospitalization duration.
Does the use of surgical drains reduce postoperative complications or length of hospital stay in patients undergoing thyroidectomy?
Systematic Review (n=4,283)
Does the use of surgical drains reduce postoperative complications or length of hospital stay in patients undergoing thyroidectomy?
Odds Ratio: 3.31 (95% CI 1.92–5.7)
Absolute Event Rate: 1.8% vs 0.5%
p-value: p=<0.001
The use of drains in thyroid surgery does not prevent typical surgical complications but is associated with increased infection risks and extended hospitalization.
Drains fail to prevent complications yet increase infections and stay; challenges routine use and supports selective application.
Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.
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HAN et al. (2024) conducted a systematic review in Patients undergoing thyroidectomy (n=4,283). Postoperative drains vs. No drain was evaluated on Postoperative infection rate (OR 3.31, 95% CI 1.92-5.70, p=<0.001). The use of drains in thyroid surgery did not reduce hematomas, bleeding, or seromas, but significantly increased the risk of postoperative infection (OR 3.31) and prolonged hospital stays.
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