갑상선 절제술 후 배액관 유치가 혈종 예방에 도움이 되는가?
Does the Drain Can Prevent Hematoma After Thyroidectomy?
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Background and Objectives Post-thyroidectomy hematoma is reported in about 0.7%-2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery toprevent swelling and hematoma. This study aims to compare clinical differences and postoperativecomplications depending on the presence or absence of a drain, and to identify the factorsaffecting hematoma after thyroidectomy. Subjects and Method This is a retrospective study of patients who underwent conventionalthyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlyingdiseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay andpostoperative complications (hematoma and vocal cord palsy) by examining medical records. Results Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients,and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s diseasecomorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroidvolume, operating time, and length of hospital stay were significantly higher in the drainplaced group (p<0.05). But there was no significant difference in the ratio of vocal cord palsyand hematoma occurrence between the two groups. In logistic regression analysis, diabetes,the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified asrisk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency afterthyroidectomy, but there was no difference in the incidence of hematoma according to drainplacement. Rather, patients’ length of hospital stay increased due to the placement of drain.
Abstract
Background and Objectives Post-thyroidectomy hematoma is reported in about 0.7%-2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery toprevent swelling and hematoma. This study aims to compare clinical differences and postoperativecomplications depending on the presence or absence of a drain, and to identify the factorsaffecting hematoma after thyroidectomy. Subjects and Method This is a retrospective study of patients who underwent conventionalthyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlyingdiseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay andpostoperative complications (hematoma and vocal cord palsy) by examining medical records. Results Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients,and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s diseasecomorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroidvolume, operating time, and length of hospital stay were significantly higher in the drainplaced group (p<0.05). But there was no significant difference in the ratio of vocal cord palsyand hematoma occurrence between the two groups. In logistic regression analysis, diabetes,the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified asrisk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency afterthyroidectomy, but there was no difference in the incidence of hematoma according to drainplacement. Rather, patients’ length of hospital stay increased due to the placement of drain.
참고문헌 (22)
- Bergenfelz A, "Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660patients", Langenbecks Arch Surg, 393(5), pp.667~673 (2008)
- de Carvalho AY, "Risk factors and outcomes of postoperative neck hematomas : an analysis of 5, 900 thyroidectomies performed at a cancer center", Int Arch Otorhinolaryngol, 25(3), pp.e421~e427 (2021)
- Rosenbaum MA, "Life-threatening neck hematoma complicating thyroid and parathyroid surgery", Am J Surg, 195(3), pp.339~343 (2008)
- Carr ER, "In vitro study investigating post neck surgery haematoma airway obstruction", J Laryngol Otol, 123(6), pp.662~665 (2009)
- Karayacin K, "Thyroidectomy with and without drains", East Afr Med J, 74(7), pp.431~432 (1997)
- Wihlborg O, "To drain or not to drain in thyroid surgery. A controlled clinical study", Arch Surg, 123(1), pp.40~41 (1988)
- Tabaqchali MA, "Drains for thyroidectomy", parathyroidectomy : fact or fiction?, 1999, pp.81(5), 302~305
- Ariyanayagam DC, "Thyroid surgery without drainage : 15 years of clinical experience", J R Coll Surg Edinb, 38(2), pp.69~70 (1993)
- George NM, "To drain or not to drain following thyroidectomy: a prospective, randomized study", Saudi Med J, 44(5), pp.518~521 (2023)
- Tian J, "Comparison of drain versus no-drain thyroidectomy : a meta-analysis", Eur Arch Otorhinolaryngol, 274(1), pp.567~577 (2017)
- Maroun CA, "Drain placement in thyroidectomy is associated with longer hospital stay without preventing hematoma", Laryngoscope, 130(5), pp.1349~1356 (2020)
- Park DH, "Comparison of negative drainage groups and no drainage groups after hemithyroidectomy", J Clin Otolaryngol Head Neck Surg, 32(1), pp.53~58 (2021)
- Shabana W, "Measuring thyroid gland volume : should we change the correction factor?", AJR Am J Roentgenol, 186(1), pp.234~236 (2006)
- Lo CY, "A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy", Arch Surg, 135(2), pp.204~207 (2000)
- Zakaria HM, "Recurrent laryngeal nerve injury in thyroid surgery", Oman Med J, 26(1), pp.34~38 (2011)
- Campbell MJ, "A multi-institutional international study of risk factors for hematoma after thyroidectomy", Surgery, 154(6), pp.1283~1289 (2013)
- Fan C, "Risk factors for neck hematoma requiring surgical re-intervention after thyroidectomy : a systematic review and meta-analysis", BMC Surg, 19(1), pp.98~ (2019)
- Fobbe F, "Appearance of thyroid diseases using colour-coded duplex sonography", Eur J Radiol, 9(1), pp.29~31 (1989)
- Caruso G, "Color Doppler measurement of blood flow in the inferior thyroid artery in patients with autoimmune thyroid diseases", Eur J Radiol, 36(1), pp.5~10 (2000)
- Goichot B, "Diagnostic procedure in suspected Graves’ disease", Ann Endocrinol(Paris), 79(6), pp.608~617 (2018)
- Brunn J, "Volumetric analysis of thyroid lobes by real-time ultrasound (author’s transl)", Dtsch Med Wochenschr, 106(41), pp.1338~1340 (1981)
- Lee HS, "Patterns of post-thyroidectomy hemorrhage", Clin Exp Otorhinolaryngol, 2(2), pp.72~77 (2009)