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Drainless thyroid surgeries including goiter or central neck dissection: a case-control study

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

Despite ample of evidence regarding feasibility of simple drainless thyroid surgeries, the evidence of feasibility of such procedures in goiters and central neck dissections remains limited.

Methods

Patients undergoing total thyroidectomy (TT) between January 2017 and July 2022 were included. The study included two study groups: drainless TT with central neck dissection (CND) and drainless TT due to goiter, which were compared to two controls: non-goiter drainless TT and drained TT for goiter or with CND. Main outcome was post-operative seroma rate.

Results

156 patients met the inclusion criteria for each of the group. No significant differences between groups were found for permanent hypocalcemia, and other complications. Post-operative seroma was found in nine patients (5.8%), all from study groups. No significant differences between groups were found for local infections, aspirations, post-discharge drain insertion.

Conclusions

Complex drainless thyroid surgeries, including goiter and CND, are feasible and do not seem to significantly increase rate of post-operative seromas or infections.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Cohen O, Ronen O, Khafif A et al (2022) Revisiting the role of surgery in the treatment of Graves’ disease. Clin Endocrinol (Oxf) 96(6):747–757. https://doi.org/10.1111/cen.14653

    Article  PubMed  Google Scholar 

  2. Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26(1):1–133. https://doi.org/10.1089/thy.2015.0020

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chen AY, Bernet VJ, Carty SE et al (2014) American thyroid association statement on optimal surgical management of goiter. Thyroid 24(2):181–189. https://doi.org/10.1089/thy.2013.0291

    Article  PubMed  Google Scholar 

  4. Wu C, Lee K, Tae K, Ji YB, Kim SW, Lee HS (2019) Recurrent laryngeal nerve (RLN) injury in thyroid surgery : lessons learned recurrent laryngeal nerve (RLN) injury in thyroid surgery : lessons learned from the intraoperative neural monitoring (IONM). Int J Head Neck Sci 1:19–26. https://doi.org/10.6696/IJHNS.2017.0101.04

    Article  Google Scholar 

  5. Khafif A, Cohen O, Masalha M, Yaish I, Hod K, Assadi N (2021) Adoption of the transoral endoscopic vestibular approach by head and neck surgeons without prior laparoscopic/robotic experience. Head Neck 43(2):496–504. https://doi.org/10.1002/hed.26503

    Article  PubMed  Google Scholar 

  6. Wang Y, Zhou S, Liu X et al (2021) Transoral endoscopic thyroidectomy vestibular approach vs conventional open thyroidectomy: meta-analysis. Head Neck 43(1):345–353. https://doi.org/10.1002/hed.26486

    Article  PubMed  Google Scholar 

  7. Terris DJ, Snyder S, Carneiro-Pla D et al (2013) American thyroid association statement on outpatient thyroidectomy. Thyroid 23(10):1193–1202. https://doi.org/10.1089/thy.2013.0049

    Article  PubMed  Google Scholar 

  8. Tartaglia N, Di Lascia A, Lizzi V et al (2016) Haemostasis in thyroid surgery: collagen-fibrinogen-thrombin patch versus cellulose gauze our experience. Surg Res Pract. https://doi.org/10.1155/2016/3058754

    Article  PubMed  PubMed Central  Google Scholar 

  9. Khadra H, Bakeer M, Hauch A, Hu T, Kandil E (2018) Hemostatic agent use in thyroid surgery: a meta-analysis. Gland Surg 7(Suppl 1):S34–S41. https://doi.org/10.21037/gs.2018.03.02

    Article  PubMed  PubMed Central  Google Scholar 

  10. Shaha AR, Jaffe BM (1993) Selective use of drains in thyroid surgery. J Surg Oncol. https://doi.org/10.1002/jso.2930520409

    Article  PubMed  Google Scholar 

  11. Tabaqchali MA, Hanson JM, Proud G (1999) Drains for thyroidectomy/parathyroidectomy: fact or fiction? Ann R Coll Surg Engl 81(5):302

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Conboy P, Brown DH (2008) Use of tissue sealant for day surgery parotidectomy. J Otolaryngol Head Neck Surg 37(2):208–211. https://doi.org/10.2310/7070.2008.0040

    Article  PubMed  Google Scholar 

  13. Crossley EJ, Biggs TC, Jog M et al (2020) Drainless head and neck surgery: a retrospective review of 156 procedures (thyroidectomy, parotidectomy and neck dissections in a tertiary setting): The Southampton experience. Clin Otolaryngol 45(6):946–951. https://doi.org/10.1111/coa.13611

    Article  PubMed  Google Scholar 

  14. Cunniffe HA, Wong BLK, Hilger AW, Burgan OT (2019) Drain-free parotidectomy: a pilot study using ARTISS fibrin sealant. Eur Arch Oto-Rhino-Laryngology 276(7):2025–2029. https://doi.org/10.1007/S00405-019-05449-X/FIGURES/3

    Article  CAS  Google Scholar 

  15. Huang CW, Wang CC, Jiang RS, Huang YC, Ho HC, Liu SA (2016) The impact of tissue glue in wound healing of head and neck patients undergoing neck dissection. Eur Arch Oto-Rhino-Laryngology 273(1):245–250. https://doi.org/10.1007/s00405-015-3709-3

    Article  Google Scholar 

  16. Karanikolic A, Djordjevic M, Djordjevic N, Golubovic I (2017) Effect of fibrin vs cellulose based haemostatic agents with traditional haemostatic procedures in thyroid surgery. Pak J Med Sci 33(6):1360. https://doi.org/10.12669/pjms.336.13692

    Article  Google Scholar 

  17. Samraj K, Gurusamy KS (2007) Wound drains following thyroid surgery. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD006099.PUB2

    Article  PubMed  PubMed Central  Google Scholar 

  18. Geraci G, D’Orazio B, Chiarenza S et al (2019) Efficacy of fibrin sealant in thyroid surgery. Is drainage still necessary? Ann Ital Chir 90:100–105

    PubMed  Google Scholar 

  19. Suslu N, Vural S, Oncel M et al (2006) Is the insertion of drains after uncomplicated thyroid surgery always necessary? Surg Today 36(3):215–218. https://doi.org/10.1007/s00595-005-3129-x

    Article  PubMed  Google Scholar 

  20. Lee SW, Choi EC, Lee YM, Lee JY, Kim SC, Koh YW (2006) Is lack of placement of drains after thyroidectomy with central neck dissection safe? A prospective, randomized study. Laryngoscope 116(9):1632–1635. https://doi.org/10.1097/01.mlg.0000231314.86486.be

    Article  PubMed  Google Scholar 

  21. Cohen O, Chaushu H, Hod K, Kirshenbaum T, Khafif A (2022) Drainless parotidectomy using tissue fibrin sealant: a retrospective case-control study. J Cranio-Maxillofac Surg 50(6):493–498. https://doi.org/10.1016/j.jcms.2022.05.002

    Article  Google Scholar 

  22. Bajwa MS, Tudur-Smith C, Shaw RJ, Schache AG (2017) Fibrin sealants in soft tissue surgery of the head and neck: A systematic review and meta-analysis of randomised controlled trials. Clin Otolaryngol 42(6):1141–1152. https://doi.org/10.1111/COA.12837

    Article  CAS  PubMed  Google Scholar 

  23. Kim TW, Choi SY, Jang MS et al (2012) Efficacy of fibrin sealant for drainage reduction in total thyroidectomy with bilateral central neck dissection. Otolaryngol Head Neck Surg (US) 147(4):654–660. https://doi.org/10.1177/0194599812449315

    Article  Google Scholar 

  24. Wihlborg O, Bergljung L, Mårtensson H (1988) To drain or not to drain in thyroid surgery: a controlled clinical study. Arch Surg 123(1):40–41. https://doi.org/10.1001/archsurg.1988.01400250042007

    Article  CAS  PubMed  Google Scholar 

  25. Hurtado-López LM, López-Romero S, Rizzo-Fuentes C, Zaldívar-Ramírez FR, Cervantes-Sánchez C (2001) Selective use of drains in thyroid surgery. Head Neck 23(3):189–193. https://doi.org/10.1002/1097-0347(200103)23:3%3c189::AID-HED1017%3e3.0.CO;2-Y

    Article  PubMed  Google Scholar 

  26. Debry C, Renou G, Fingerhut A (1999) Drainage after thyroid surgery: a prospective randomized study. J Laryngol Otol 113(1):49–51. https://doi.org/10.1017/s0022215100143129

    Article  CAS  PubMed  Google Scholar 

  27. Kristoffersson A, Sandzén B, Järhult J (1986) Drainage in uncomplicated thyroid and parathyroid surgery. Br J Surg 73(2):121–122. https://doi.org/10.1002/bjs.1800730215

    Article  CAS  PubMed  Google Scholar 

  28. Schoretsanitis G, Melissas J, Sanidas E, Christodoulakis M, Vlachonikolis JG, Tsiftsis DD (1998) Does draining the neck affect morbidity following thyroid surgery? Am Surg 64(8):778–780

    CAS  PubMed  Google Scholar 

  29. Dogan L, Karaman N, Yilmaz KB, Ozaslan C, Atalay C (2011) Total thyroidectomy for the surgical treatment of multinodular goiter. Surg Today 41(3):323–327. https://doi.org/10.1007/s00595-009-4272-6

    Article  PubMed  Google Scholar 

  30. Randolph GW, Shin JJ, Grillo HC et al (2011) The surgical management of goiter: Part II. Surgical treatment and results. Laryngoscope 121(1):68–76. https://doi.org/10.1002/lary.21091

    Article  PubMed  Google Scholar 

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Funding

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Authors and Affiliations

  1. ARM-Center for Otolaryngology-Head and Neck Surgery Center and Oncology, Assuta Medical Center, 20 Habarzel Street, Tel Aviv, Israel

    Oded Cohen, Noa Dagul Amiad, Eitan Shavit & Avi Khafif

  2. Ben Gurion University of the Negev, Beer Sheva, Israel

    Oded Cohen, Keren Hod & Avi Khafif

  3. Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel

    Oded Cohen

  4. Department of Academy and Research, Assuta Medical Centers, Tel Aviv, Israel

    Keren Hod

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  1. Oded Cohen
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  5. Avi Khafif
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Contributions

OC: conception and design of study, acquisition of clinical data, analysis of data, drafting of article and critical revision, final approval of manuscript. NDA: design of study, acquisition of clinical data, analysis of data critical revision, final approval of manuscript. EGS: design of study, acquisition of clinical data, analysis of data critical revision, final approval of manuscript. KH: design of study, analysis of data, drafting of article and critical revision, final approval of manuscript. AK: conception and design of study, analysis of data, drafting of article and critical revision, final approval of manuscript.

Corresponding author

Correspondence to Oded Cohen.

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All authors declare no conflict of interest in connection with this article.

Ethical approval

The study was approved by Assuta Medical Center review Board.

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Was waivered by the IRB.

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Cohen, O., Amiad, N.D., Shavit, E. et al. Drainless thyroid surgeries including goiter or central neck dissection: a case-control study. Eur Arch Otorhinolaryngol 281, 1435–1441 (2024). https://doi.org/10.1007/s00405-023-08343-9

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  • DOI: https://doi.org/10.1007/s00405-023-08343-9

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