Abstract:
ABSTRACT
Background: Prophylactic drainage after thyroid surgery is still common practice among
surgeons despite no tangible scientific evidence to support its benefits. Current evidence suggests
its usage to be harmful to the patients as they are linked to infections, hematoma and increased
levels of pain. So far, there are no consensus in current Rwandan surgical practice. The main
purpose of this study was to investigate the levels of pain in patients with drainage after thyroid
surgery.
Methodology: It was a prospective clinical trial done at CHUK and KRH from January to June
2020. In total, 34 patients were enrolled in two arms: the first group received a drain
postoperatively while the second group did not receive any type of drainage.
Results: the rate of haematoma and seroma formation was the same in the drain and the no-drain
group (P=0.628). There was no case of wound dehiscence in both groups and only 1 case of
wound infection in the no-drain group.
The mean average pain score after 6 hours was: 5 (±2.02) in the drain group and 6 (±1.39) in the
no-drain group. The mean average pain score after 24 hours was: 3 (± 1.8) in the drain group and
4 (± 1.67) in the no drain group.
Most of the patients in the drain group had dysphagia (P=0.03) and more prone to dysphonia
within the first six hours postoperatively. However, those signs and symptoms would disappear
within 24 hours.
Conclusions: the prophylactic drainage after thyroid surgery displayed no tangible benefits and
there is evidence of discomfort among patients with a drain. However, due to the inherent
limitations of our study, we could not link drainage to higher postoperative pain levels.
Therefore, we recommend bigger and multi-center clinical trials to better investigate the impact
of the drainage on postoperative pain and other complications related to thyroid surgery.
