Battoo Azhar Jan, Haji Altaf Gauhar, Sheikh Zahoor Ahmad, Thankappan Krishnakumar, Mir Wahid Abdul
Department of Surgical Oncology, Sher i Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India.
Department of Head and Neck Surgical Oncology, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India.
Int Arch Otorhinolaryngol. 2018 Jul;22(3):256-259. doi: 10.1055/s-0037-1606183. Epub 2017 Oct 25.
There is difference of opinion about the placement of the drain in thyroid surgeries, and, to the best of our knowledge, the efficacy of drainless total thyroidectomy regarding various parameters of thyroid lesions has not been well-established. To report our experience with drainless total thyroidectomy, and to define an appropriate patient population for its performance. This is a retrospective case analysis of the patients who underwent total thyroidectomy for intrathyroidal lesions with or without central neck dissection in a tertiary referral hospital (number = 74). The patients, who had undergone total thyroidectomy without any drain insertion, were analyzed, and the relationships among various parameters of thyroid lesions were noted in relation to seroma and hematoma formation. Seroma formation was noted only in 5 out of 74 patents (6.75%). All of the seromas that occurred were observed in patients with thyroid lesions < 4 cm, and 4 out of 5 seromas were observed in patients with a malignant pathology. There was no statistically significant difference in seroma formation between patients younger or older than 50 years of age. The nature of the lesion, whether benign or malignant, did not affect the formation of seroma. Of interest is the fact that none of the 10 patients who had central neck dissection performed as part of their treatment developed seroma. Drainless total thyroidectomy is safe across all age groups for patients harboring either benign or malignant thyroid pathologies. However, caution is to be observed in opting for drainless total thyroidectomy in patients with large lesions (> 5 cm).
关于甲状腺手术中引流管的放置存在不同意见，据我们所知，无引流全甲状腺切除术在甲状腺病变的各种参数方面的疗效尚未得到充分证实。
报告我们在无引流全甲状腺切除术中的经验，并确定适合进行该手术的患者群体。
这是对一家三级转诊医院中因甲状腺内病变接受全甲状腺切除术（无论是否进行中央区颈清扫）的患者进行的回顾性病例分析（病例数 = 74）。对未插入任何引流管而接受全甲状腺切除术的患者进行分析，并记录甲状腺病变的各种参数与血清肿和血肿形成之间的关系。
在74例患者中，仅5例（6.75%）出现血清肿。所有发生血清肿的患者甲状腺病变均<4 cm，5例血清肿中有4例出现在病理为恶性的患者中。年龄小于或大于50岁的患者在血清肿形成方面无统计学显著差异。病变的性质，无论是良性还是恶性，均不影响血清肿的形成。有趣的是，作为治疗一部分进行中央区颈清扫的10例患者中无一例发生血清肿。
对于患有良性或恶性甲状腺病变的所有年龄组患者，无引流全甲状腺切除术都是安全的。然而，对于病变较大（>5 cm）的患者，选择无引流全甲状腺切除术时应谨慎。
