Thyroidectomy: no place for routine drainage- experience of two centres

Abstract

INTRODUCTION: Insertion of drains following thyroidectomy is considered a 'hallowed' practice. This practice has remained unchallenged because of fear and tradition. There is sufficient scientific evidence to show that routine drainage following thyroidectomy is not necessary. METHODS: Twosimultaneousprospective studieswere undertaken at University Surgical uriits of'Kelaniya and Peradeniya 150 patients undergoing elective thyroidectomy from 1999to 2002 were included in thestudy, The researcher in Kelaniya had NOT undertaken routine drainage for several years arid 100 consecutivepatientsundergoingthyroidectomywithout drainage were included in the study In Peradeniya 25 patients underwent thyroidectomy with drains and 25 patients underwent thyroidectomy without drains. All types of thyroidectomies were included in the study. Total- Thyroidectomy - 23 (Kelaniya) ,- 03 (Peradeniya) Subtoal - thyroidectomy - IO (Kelaniya),- 29 (Peradeniya) Thyroid- Lobectomy - 55 (Kelaniya) ,- 18 (Peradeniya) Redo- Thyroidectomies - 12 (Kelaniya) Parameters assessed: 1. Prospective complications - Wound infection, Haematoma, Hypocalcaernia and Recurrent laryngeal nerve injury 2 Re-exploration and indications RESULTS: Wound infection rate:With drains-8% Hypocalcaemia-1%(permanent) Without drains-0% (both groups) Wound Haematoma: With drains-6% Nerve injury-2% (transient) Without drains-2%(Seroma) (both groups) No patient required re-exploration for a life threatening complication in either group. CONCLUSIONS: 1. Thyroidectomy without drainage can be done safely. 2. Routine drainage in thyroidectomy is NOT indicated