Drain Versus No-Drainage After Thyroidectomy For Patients With Thyroid Disease

Objective:To clarify the clinical effectiveness of placing drainage and no-drainage after thyroidectomy,and evaluate its safety and adverse reactions.Methods:1.The databases were retrieved orderly from the date of their establishment to November 29th,2016,which included PubMed,The Cochrane Library(the first phase of 2016),Wan Fang Date and so on.The literature was screened strictly according to inclusive criteria.After study selection,included studies assessment and data extraction conducted by two reviewers independently.The meta-analyses were performed by using RevMan5.3 soft ware.The level of evidence and strength of recommendation were assessed by using the GRADEpro3.6 soft ware;2.From September 2015 to March 2017 a retrospective study of a series of patients who underwent thyroidectomy because of thyroid diseases.The patients were all from the Department of general surgery in Second Hospital Affiliated to Lanzhou University.According to the drainage or no-drainage after thyroidectomy,the patients were divided into drainage group and no-drainage group.Statistical analyses were performed using the statistical package for the social sciences(SPSS)software version 22.0.A comparison in the baseline characteristics,preoperative clinical data,intraoperative clinical data,postoperative clinical data,the duration of hospital stay and hospitalization expenses was done between the two groups.Results:1.A total of 21 studies involving 2836 participants were included.There were no significant differences between the two groups in the rate of re-operation,hematoma,sermon,hemorrhage,slight bulge in the neck that don't need to deal with.However,the wound infection rate was significantly different between the two groups[RR=2.65,95%CI(1.31,5.34),I~2=0%,P=0.006];as were incision pain score for the intraday after operation[SMD=0.70,95%CI(0.26 to 1.14),I~2=76%,P=0.002],and the first day after operation[SMD=1.26,95%CI(0.75 to 1.77),I~2=93%,P<0.000 1];and the duration of hospital stay also was significantly difference[SMD=1.66,95%CI(1.19 to 2.13),I~2=96%,P<0.000 01].2.A total of 257 patients were included.There were no significant differences in the baseline characteristics,preoperative clinical data,intraoperative clinical data,postoperative clinical data between the two groups(P>0.05),except in the duration of hospital stay(5.48±1.83days for drainage group and 4.21±1.56 days for no-drainage group,P<0.05),and in the hospitalization expenses(14501.84±2911.56 yuan for drainage group and10501.68±2129.68 yuan for no-drainage group,P<0.05)between the two groups.Conclusions:1.The routine drainage after thyroidectomy for patients with thyroid disease can not reduce the incidence of postoperative complications,however increase the rates of wound infection,the incision pain score and the duration of hospital stay.2.Negative drainage after thyroidectomy for patients with thyroid disease,would result in decreased the duration of hospital stay and lessen expenses,and without increased the postoperative complications.