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Thyroidectomy: A Comparison of Drain and No-Drain Strategies

Ahmed Hussain Pathan
Associate Professor General Surgery, Liaquat University of Medical and Health Sciences Jamshoro Pakistan.
Karim Bux
Senior Registrar General Surgery, Liaquat University of Medical and Health Sciences Jamshoro Pakistan.
Sandesh Kumar
Assistant Professor General Surgery, Liaquat University of Medical and Health Sciences Jamshoro Pakistan.
Shahbaz Zahoor
Senior Medical Officer General Surgery, Peoples University of Medical and Health Sciences Nawabshah Pakistan.
Syed Moin Islam Shah
Assistant Professor General Surgery, Sulaman Roshan Medical College Tandoadam Pakistan.
Rihan Aslam Khan
Post Graduate Trainee General Surgery, Ziauddin Hospital Keamari Karachi Pakistan.

Abstract

Objective: To evaluate the differences in the effectiveness of thyroidectomy with and without a drain.

Background: The thyroid gland converts iodine from our food into two primary active forms: triiodothyronine (T4) and thyroxine (T3). Neck hematomas, an unusual but dangerous consequence, can arise as a result of faulty hemostasis or a bleeding problem, and while the yearly incidence is just 1%, they can asphyxiate the patient and create airway blockage. It has also been shown that employing a drain after basic thyroid surgery is futile. Study design: A randomized controlled trial Place and Duration: This study was conducted in Liaquat University of Medical and Health Sciences Jamshoro from October 2022 to October 2023. Methodology: This study was carried out among 140 patients with consent from the hospital's ethics review committee. Participants in our study were those who had a palpable or noticeable enlargement of the thyroid gland, regardless of size. Group A comprised patients with drains, while Group B included patients without drains. For three days, every patient in both groups was observed. When the drainage was less than 20 millilitres per day, the drain was sealed. A statistically significant p value was one that was less than 5%. Results: It was observed that 26 (37.14%) males were in group A and 22 (31.43%) in group B; the proportion of females was higher than that of males, being 44 (62.86%) and 48 (68.57%) in groups A and B, respectively. Suction drain efficacy was observed in both groups in terms of resulting in no hematoma formation. The efficacy was observed at 72.86% and 70% in groups A and B respectively with a p value of 0.42. There was no hematoma in 75% of females in group A and 72.92% of females in group B. Conclusion: This study shows that precise dissection and hemostasis cannot be replaced with drains. Although the patient may have felt less pain after thyroid surgery, the absence of drains was not linked to any problems.

Keywords: Thyroidectomy, Drain, Hematoma. ,

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