A Comparison of Pain Score, Hospital Stay, and Post-operative Complications between With or Without Postoperative Drain Replacement in Patients Undergoing Hemithyroidectomy at Burapha University Hospital: A Randomized Controlled Trial
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Abstract
BACKGROUND: A hemithyroidectomy is the treatment of choice for patients with a unilateral thyroid nodule. While postoperative drainage replacement is a common practice to avoid serious airway compression from a hematoma or seroma, it may cause other complications such as a hematoma from obstructed drainage, infection, pain, and increased length of hospital stay.
OBJECTIVES: To compare the effect(s) of a postoperative hemithyroidectomy with and without drainage.
METHODS: 30 adult patients with thyroid nodules who underwent a hemithyroidectomy were enrolled. All participants were randomly assigned to two groups, one group with and one group without postoperative drainage. Postoperative pain documented by using the Visual Analogue Scale (VAS), the amount of analgesic and length of hospital stay were recorded. The presence of a hematoma, seroma and wound infection was assessed. All participants received follow-up on the 1st-7th and 14th days after operation.
RESULTS: Postoperative pain on the 1st-4th days in the non-drainage replacement group (3.2±1.1, 1.9±1.2, 0.8±0.9, and 0.3±0.5 points, respectively) showed statistically significant differences compared to the drainage replacement group (5.2±1.6, 3.5±1.2, 2.5±2.0, and 0.9±0.8 points, respectively) (p=0.001, 0.003, 0.003, and 0.03, respectively). The amount of analgesic was also reduced (non-drainage group with 2, 2, 0 doses; drainage group 8, 5, 4 doses), along with a statistically significant reduction in the length of stay (non-drainage group at 1.0±0.0 days and drainage group at 2.7±0.5 days, p<0.001). No presence of hematoma, seroma, or wound infection was found in either group.
CONCLUSION: A hemithyroidectomy without drainage is superior to drain replacement in terms of less postoperative pain, a lower amount of analgesic, and shorter length of stay with no serious complications.
Thaiclinicaltrials.org number, TCTR20220308004
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