title: Efficacy of fibrin sealant for drainage reduction in total thyroidectomy with bilateral central neck dissection.
abstract: OBJECTIVE
  To investigate the efficacy of fibrin sealant (FS) for reducing postoperative drainage in patients who underwent total thyroidectomy (TT) with bilateral central neck dissection (CND) for papillary thyroid cancer.
  
  
  METHODS
  Prospective randomized trial.
  
  
  METHODS
  Tertiary care institution.
  
  
  METHODS
  Seventy-eight patients with papillary thyroid cancer were enrolled and randomized to either the FS application group (FS+, 38 patients) or no FS application group (FS-, 40 patients). In both groups, postoperative drainage amounts were measured by a negative suction system until the criterion of drain removal was met. Drainage amounts as well as the time to drain removal, postoperative complications, and chemical profile assay of drain fluids between the 2 groups were performed.
  
  
  RESULTS
  Drainage amounts at the initial 24 hours as well as total amounts of the FS+ group tended to be lower than those of the FS- group; however, they were not statistically different (at initial 24 hours, 64.3 ± 17.5 mL vs 73.0 ± 18.0 mL, P = .06; total amounts, 93.5 ± 30.7 mL vs 105.7 ± 31.2 mL, P = .05). The FS application did not shorten the time to drain removal even when different criteria for drain removal were applied (criteria of <20 mL/d or <30 mL/d). When chemistry profiles of collected drain fluids were analyzed in patient subgroups, the level of triglycerides in the FS+ group was significantly lower than in the FS- group.
  
  
  CONCLUSIONS
  Fibrin sealant has no additional advantage in terms of drainage reduction and early discharge despite the additional medical cost.
authors.affiliation: Department of Otorhinolaryngology, Sejong General Hospital, Bucheon, South Korea.
authors.forename: Tae Wook
authors.initials: TW
authors.lastname: Kim
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Choi
authors.forename: Min-Seok
authors.initials: MS
authors.lastname: Jang
authors.forename: Gang-Gyu
authors.initials: GG
authors.lastname: Lee
authors.forename: Myung-Eun
authors.initials: ME
authors.lastname: Nam
authors.forename: Young-Ik
authors.initials: YI
authors.lastname: Son
authors.forename: Man Ki
authors.initials: MK
authors.lastname: Chung
mesh_terms: D002291:Carcinoma, Papillary / Q000601:surgery*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004322:Drainage; D005122:Exudates and Transudates / Q000737:chemistry; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive