Brief Article
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World J Otorhinolaryngol. Feb 28, 2014; 4(1): 1-5
Published online Feb 28, 2014. doi: 10.5319/wjo.v4.i1.1
Classic clamp-and-tie total thyroidectomy for large goiters in the modern era: To drain or not to drain
Theodossis S Papavramidis, Ioannis Pliakos, Nick Michalopoulos, George Mistriotis, Niko Panteli, George Gkoutzamanis, Spiros Papavramidis
Theodossis S Papavramidis, Ioannis Pliakos, Nick Michalopoulos, George Mistriotis, Niko Panteli, George Gkoutzamanis, Spiros Papavramidis, 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, 54655 Thessaloniki, Greece
Author contributions: All the authors contributed to this paper equally.
Correspondence to: Theodossis S Papavramidis, MD, PhD, 3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, 6 Aigaiou Str., 54655 Thessaloniki, Greece. papavramidis@hotmail.com
Telephone: +30-694-4536972 Fax: +30-694-4536972
Received: June 9, 2013
Revised: October 28, 2013
Accepted: December 9, 2013
Published online: February 28, 2014
Abstract

AIM: To evaluate the role of drains in clamp-and-tie total thyroidectomy (cTT) for large goiters.

METHODS: A hundred patients were randomized into group D (drains maintained for 24 h) and ND (no drains). We recorded epidemiological characteristics, thyroid pathology, hemostatic material, intraoperative events, operative time and difficulty, blood loss, biochemical and hematological data, postoperative vocal alteration and pain, discomfort, complications, blood in drains, and hospitalization.

RESULTS: The groups had comparable preoperative characteristics, pathology, intraoperative and postoperative data. Hemostatic material was used in all patients of group ND. Forty patients in group D and 9 in ND felt discomfort (P < 0.001).

CONCLUSION: Drains in cTT for large goiters give no advantage or disadvantage to the surgeon. The only “major disadvantage” is the discomfort for the patient. Inversely, drains probably influence surgeons’ serenity, especially when cTT is performed in nonspecialized departments.

Keywords: Total thyroidectomy, Drains, Postoperative complications, Postoperative hemorrhage, Discomfort

Core tip: The present aim is to elucidate the significance of drains in thyroid surgery for large goiters in the modern era. The authors conclude that there are two major parameters that influence the placement of drains: the surgeon’s experience and the patient’s discomfort.