Colak Tahsin, Akca Tamer, Turkmenoglu Ozgur, Canbaz Hakan, Ustunsoy Bora, Kanik Arzu, Aydin Suha
Department of General Surgery, Medical Faculty of Mersin University, 33079 Mersin, Turkey.
J Zhejiang Univ Sci B. 2008 Apr;9(4):319-23. doi: 10.1631/jzus.B0720257.
This prospective randomized clinical trial was conducted to evaluate the necessity of drainage after total thyroidectomy or lobectomy for benign thyroidal disorders.
A total of 116 patients who underwent total thyroidectomy or lobectomy for benign thyroidal disorders were randomly allocated to be drained or not. Operative and postoperative outcomes including operating time, postoperative pain assessed by visual analogue scale (VAS), total amount of intramuscular analgesic administration, hospital stay, complications, necessity for re-operation and satisfaction of patients were all assessed.
The mean operating time was similar between two groups (the drained and non-drained groups). The mean VAS score was found to be significantly low in the non-drained group patients in postoperative day (POD) 0 and POD 1. The mean amount of intramuscular analgesic requirement was significantly less in the non-drained group. One case of hematoma, two cases of seroma and three cases of transient hypoparathyroidism occurred in the non-drained group, whereas one case of hematoma, two cases of seroma, two cases of wound infections and two cases of transient hypoparathyroidism occurred in the drained group. No patient needed re-operation for any complication. The mean hospital stay was significantly shorter and the satisfaction of patients was superior in the non-drained group.
These findings suggest that postoperative complications cannot be prevented by using drains after total thyroidectomy or lobectomy for benign thyroid disorders. Furthermore, the use of drains may increase postoperative pain and the analgesic requirement, and prolong the hospital stay. In the light of these findings, the routine use of drains might not be necessary after thyroid surgery for benign disorders.
本前瞻性随机临床试验旨在评估良性甲状腺疾病行全甲状腺切除术或甲状腺叶切除术后引流的必要性。
116例因良性甲状腺疾病接受全甲状腺切除术或甲状腺叶切除术的患者被随机分为引流组和非引流组。评估手术及术后结果,包括手术时间、采用视觉模拟评分法(VAS)评估的术后疼痛、肌肉注射镇痛药物的总量、住院时间、并发症、再次手术的必要性及患者满意度。
两组(引流组和非引流组)的平均手术时间相似。非引流组患者术后第0天和第1天的平均VAS评分显著较低。非引流组肌肉注射镇痛药物的平均需求量显著较少。非引流组发生1例血肿、2例血清肿和3例暂时性甲状旁腺功能减退,而引流组发生1例血肿、2例血清肿、2例伤口感染和2例暂时性甲状旁腺功能减退。无患者因任何并发症需要再次手术。非引流组的平均住院时间显著较短,患者满意度更高。
这些结果表明,良性甲状腺疾病行全甲状腺切除术或甲状腺叶切除术后使用引流管并不能预防术后并发症。此外,使用引流管可能会增加术后疼痛和镇痛药物需求量,并延长住院时间。鉴于这些结果,良性甲状腺疾病手术后可能无需常规使用引流管。