A randomised controlled trial of routine suction drainage after elective thyroid and parathyroid surgery with ultrasound evaluation of fluid collection.
OBJECTIVE
To determine the need for suction drainage after elective thyroid and parathyroid surgery.


METHODS
Randomised controlled trial.


METHODS
University teaching hospital.


METHODS
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.


METHODS
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).


CONCLUSIONS
Routine suction drainage after uncomplicated elective thyroid and parathyroid surgery appears unnecessary, and prolongs in-patient stay.
Ahluwalia
S
S
Department of Otorhinolaryngology - Head and Neck Surgery, St Mary's Hospital, London, UK. mail@suki.org.uk
Hannan
S A
SA
Mehrzad
H
H
Crofton
M
M
Tolley
N S
NS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004487:Edema / Q000000981:diagnostic imaging* / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000379:methods*; D013507:Endocrine Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009333:Neck; D010280:Parathyroid Glands / Q000601:surgery*; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D013396:Suction / Q000379:methods; D013961:Thyroid Gland / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography