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A randomised controlled trial of routine suction drainage after elective thyroid and parathyroid surgery with ultrasound evaluation of fluid collection
Author(s) -
Ahluwalia S.,
Hannan S.A.,
Mehrzad H.,
Crofton M.,
Tolley N.S.
Publication year - 2007
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/j.1365-2273.2007.01382.x
Subject(s) - medicine , surgery , thyroid , complication , drainage , randomized controlled trial , ecology , biology
Objective: To determine the need for suction drainage after elective thyroid and parathyroid surgery. Design: Randomised controlled trial. Setting: University teaching hospital. Participants: Patients requiring elective thyroid or parathyroid surgery were recruited and informed consent was obtained ( n = 100). Before wound closure, patients were randomised into either group A (to remain without suction drainage) or group B (to receive suction drainage). Excluded patients were those requiring associated neck dissection and those with bleeding diatheses, all of whom would necessarily require drainage in our unit. Main outcome measures: Primary – ultrasound evaluation of any collection in the thyroid bed, performed 1‐day postoperatively. Secondary – postoperative complications; length of in‐patient stay. Results: One hundred patients completed the study, and groups A and B comprised 50 patients each. Patients in each group exhibited a mean age of 49 years, and a male to female ratio of 1 : 9. Both groups were also well‐matched regarding type of operation, size of tumour and histopathological diagnosis. Modal and median postoperative neck collection volume on ultrasound examination was 0 and 0 cm 3 respectively (range 0–16 cm 3 ) in group A and was 0 and 0 cm 3 (range 0–70 cm 3 ) in group B. This difference was not statistically significant, but three patients with a haematoma were all in the suction drainage group. Difference in complication rates between groups was also not statistically significant. Modal and median length of in‐patient stay was 2 and 2 days respectively (range 2–3 days) in group A and 3 and 3 days (range 2–4 days) in group B, and this difference was statistically significant ( P = 0.0006). Conclusion: Routine suction drainage after uncomplicated elective thyroid and parathyroid surgery appears unnecessary, and prolongs in‐patient stay.