Impact of Drain Placement on Postoperative Complications after Thyroidectomy for Substernal Goiter.

Autor: Waqar U; Medical College, Aga Khan University, Karachi, Pakistan., Hameed AN; Medical College, Aga Khan University, Karachi, Pakistan., Angez M; Medical College, Aga Khan University, Karachi, Pakistan., Kumar S; Medical College, Aga Khan University, Karachi, Pakistan., Arshad H; Medical College, Aga Khan University, Karachi, Pakistan., Siddiqui MT; Medical College, Aga Khan University, Karachi, Pakistan., Khan H; Medical College, Aga Khan University, Karachi, Pakistan., Viquar W; Medical College, Aga Khan University, Karachi, Pakistan., Abbas A; Medical College, Aga Khan University, Karachi, Pakistan., Javid A; Medical College, Aga Khan University, Karachi, Pakistan., Iftikhar H; Department of Surgery, University Hospitals Birmingham, United Kingdom., Abbas SA; Department of Surgery, Section of Otolaryngology, Head and Neck Surgery, Aga Khan University Hospital, Karachi, Pakistan., Naz H; Gastroenterology and Surgery Service Line, Aga Khan University Hospital, Karachi, Pakistan., Saleem S; Department of Community Health Sciences, Medical College, Aga Khan University, Karachi, Pakistan.
Jazyk: angličtina
Zdroj: International archives of otorhinolaryngology [Int Arch Otorhinolaryngol] 2024 Mar 15; Vol. 28 (3), pp. e451-e459. Date of Electronic Publication: 2024 Mar 15 (Print Publication: 2024).
DOI: 10.1055/s-0043-1777804
Abstrakt: Introduction  Despite the evidence against drain placement after thyroidectomy, there is a lack of consensus on drain use in patients with substernal goiter. Objective  To assess the factors that increase the likelihood of drain placement and its impact on postoperative hematoma and other 30-day complications among adult patients undergoing thyroidectomy for substernal goiter. Methods  A retrospective cohort study that used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Adult patients (aged ≥ 18 years) who underwent elective thyroidectomy for substernal goiter from 2016 to 2020 were included. Cases with closed suction neck drains placed upon completion of surgery were included in the drain group, and the remaining cases formed the nondrain group. Results  A total of 1,229 patients were included (46.5% with drain placement). The factors that increased the likelihood of drain placement included body mass index (BMI) ≥ 30 kg/m 2 , score between 3 and 5 on the American Society of Anesthesiologists (ASA) physical status classification, sternal split/transthoracic surgical approach, operative time ≥ 90 minutes, and surgery conducted by otolaryngologists. Patients with clean-contaminated or contaminated wound classifications were less likely to be submitted to drain placement. In addition, drain use had no impact on postoperative hematoma formation but was found to independently increase the risk of prolonged length of hospital stay. Conclusion  Thyroidectomy without drain placement might be safe for substernal goiter. However, this decision should be individualized for each patient. Level Of Evidence: 3.
Competing Interests: Conflict of Interests The authors have no conflict of interests to declare.
(The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ( https://creativecommons.org/licenses/by/4.0/ ).)
Databáze: MEDLINE
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