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갑상선수술에서 배액관 사용의 필요성: 체계적 문헌고찰과 메타분석

Necessity of Using Drains in Thyroid Surgery: Systematic Review and Meta-Analysis

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주제분류이비인후과학

초록

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland,often leads to significant postoperative bleeding. This study assesses the efficacy of usingdrains to prevent complications such as hematomas, seromas, and bleeding, and their impacton infection rates and hospitalization duration post-thyroidectomy. Following the PRISMAguidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Li-brary, including randomized controlled trials and published prospective studies on patients un-dergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative compli-cations and the length of hospital stay as primary outcomes. Thirty-five studies with 4283participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed nosignificant reduction in hematomas, bleeding, or seroma formation in the drain group. Howev-er, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence in-terval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impactthe prevention of typical surgical complications but is linked to increased infection risks andextended hospitalization. These findings challenge the conventional practice of utilizing drainsin thyroidectomy, highlighting the necessity for a tailored approach based on individual patientassessments.

Abstract

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland,often leads to significant postoperative bleeding. This study assesses the efficacy of usingdrains to prevent complications such as hematomas, seromas, and bleeding, and their impacton infection rates and hospitalization duration post-thyroidectomy. Following the PRISMAguidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Li-brary, including randomized controlled trials and published prospective studies on patients un-dergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative compli-cations and the length of hospital stay as primary outcomes. Thirty-five studies with 4283participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed nosignificant reduction in hematomas, bleeding, or seroma formation in the drain group. Howev-er, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence in-terval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impactthe prevention of typical surgical complications but is linked to increased infection risks andextended hospitalization. These findings challenge the conventional practice of utilizing drainsin thyroidectomy, highlighting the necessity for a tailored approach based on individual patientassessments.

참고문헌 (48)

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