Discussion
Hashimoto’s thyroiditis, acute postoperative bleeding, postoperative hematoma, numbness, pain, postoperative infection
SCAR, POSTOPERATIVE COMPLICATIONS, BLOOD CLOTS, WOUND INFECTION, RETROSTERNAL GOITER, POSTOPERATIVE BLEEDING, POSTOPERATIVE INFECTION, CAVITY, EFFUSION, SCARRING, LYMPHOCYTIC THYROIDITIS, COMPLICATIONS
Drainage is widely used by many surgeons during thyroid surgery. Many surgeons use drainage tube for every patient after thyroid surgery under the belief that the use of drainage devices can help eliminate exudation and dead space and identify earlier the occurrence of acute postoperative bleeding, which would allow for timely intervention. However, most American and European medical centers do not routinely place drainage tubes for thyroid surgery.Reported have indicated that routine placement of drainage devices after thyroid surgery cannot improve the prognosis of patients but rather increases the risk of postoperative infection and discomfort in the incision area (In this study, significant differences were not observed between the two groups in terms of sex, age, weight, BMI, incision length, specimen volume, number of cleared lymph nodes, and proportion of patients with lymphocytic thyroiditis. The similarity reduces the confounding factors that affect other variables. In addition, the surgeon did not know until after the operation, which ensured that bias was reduced. Because of the surgeons were blinded to the assignment until the end of the operation, surgical conduct would not have been influenced by the assignment.Compared with the drainage volume of the drainage group patients, the cervical effusion volume was significantly reduced in the non-drainage group. This indicates that the existence of a drainage tube may lead to an increase in postoperative exudation, which may be related to stimulation by the drainage tube. The drainage tube stimulates serosa exudation, resulting in a significant increase in drainage in patients in the drainage group (For patients exhibiting acute postoperative bleeding, the drainage device frequently does not draw blood in time due to blockage by blood clots (Studies have shown that routine placement of a drainage tube after thyroid surgery not only increases the risk of postoperative hematoma, wound infection, and other complications (Compared with the non-drainage group, neck discomfort was higher in the drainage group during hospitalization because implanting a drainage device is an invasive operation from the thyroid residual cavity to the outside body, which increases the pain and numbness of the surgical incision in the drainage group patients and a sensation of a foreign body in the neck. The exudation of the residual cavity of the patient follows the drainage tube to the body, resulting in a wetness of the dressing, and the drainage group patients indicated an increase in discomfort. Due to the significant reduction in exudation in patients in the non-drainage group and their faster recovery and increased neck comfort, the hospitalization days and costs were decreased accordingly.In thyroid surgery, the aesthetic needs of patients have become one of the most important factors affecting patient satisfaction because of the specific location of the incision. The placement of the drainage tube at the incision site has a negative effect on incision healing. If the drainage tube is drawn from outside the incision, it will leave an additional surgical scar at site of the incision. This not only reduces patient comfort but also affects the overall aesthetics of the patient’s neck (Not placing a drainage tube after thyroid surgery may increase certain complications. For example, in patients with larger wound surgery, such as retrosternal goiter and Hashimoto’s thyroiditis, it may be necessary to place a drainage tube for better postoperative observations. However, this view is controversial, and some studies have suggested that postoperative thyroid drainage is not associated with the extent of the surgical wound (In conclusion, not placing a drainage tube after surgery improved outcomes for patients after unilateral thyroid lobectomy and central neck dissection and could benefit patients because of the shorter hospitalization times, lower hospitalization costs, less postoperative discomfort, and fewer scarring issues without increasing the incidence of postoperative complications.