COMPARISON OF OUTCOME OF SOLITARY THYROID NODULE SURGERY WITH AND WITHOUT DRAINAGE

Abstract

Background: Majority of surgeons place a drain following thyroid surgery to evacuate collected blood and serum.
The aim of this study was to compare the outcome of thyroid surgery with and without drainage.
Material & Methods: This randomized clinical trial was conducted at Surgical Department, Jinnah Postgraduate
Medical Centre and Dow University Hospital, Karachi from August 2013 to January 2014. Inclusion criteria were
age between 18-65 years, either gender, solitary thyroid nodule with maximum size 3x3 cm, ASA physical status
I and II, euthyroid patients undergoing thyroidectomy and duration of disease >6 months. Exclusion criteria were
bleeding diathesis, multinoduler goiter, thyroid cancer, previous thyroid surgery and anticoagulant therapy. In
group A drain was placed and in group B no drain was placed. Pain score on first postoperative day and duration
of hospital stay were noted on visual analog scale (VAS).
Results: In Group A the median IQR of postoperative hospital stay was 2(1-2) and in Group B 1(1-1). In Group A
the median IQR of pain on 1st postoperative day on VAS was 2(2-3) and in Group B 1(1-1). Pain was observed in
Group A in 6.7% patients VAS score 1, in 53.3% patients 2, in 36.7% patients 3 and in 3.3% patients 4. In Group
B 83.3% patients had VAS score 1, 13.3% had 2, 3.3% had 3 and 0% VAS score 4. In group A 36.7% patients
were discharged on 1st postoperative day, 53.3% on 2nd and 10.0% on 3rd postoperative day. In Group B 93.3%
patients were discharged on 1st postoperative day, 6.7% on 2nd and 0% on 3rd postoperative day.
Conclusion: Routine drainage of thyroidectomy bed is unnecessary after uncomplicated thyroid surgery, as it is
not effective in decreasing the rate of postoperative complications resulting from post thyroidectomy haemorrhage.