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Thyroid Surgery with Drain Versus without Drain

Authors: Ammar Noori Muhammed --- Wassem Ahmed AL-Kateb --- Ramez AL-Mukhtar --- Tharwat Idrees Sulaiman
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 3 Pages: 343-348
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:The nature and indications for thyroid surgery vary and a perceived risk of postoperative complications such as seroma , haematoma , wound infection and haemorrhage post-surgery is one reason why wound drains are frequently inserted. They are generally used as a matter of the surgeon’s habit or preference more than a matter of proven benefit in the patient’s postoperative period.OBJECTIVE:To evaluate the differences in outcome and complications following thyroid surgery whether draining the wound or not .PATIENTS AND METHODS:One hundred forty five patients with different thyroid diseases requiring surgical intervention presenting to the first surgical unit in Baghdad teaching hospital between the first of October 2007 to the 31th of December 2009(27 months period) were enrolled. Patients were divided into two groups : those who had their wounds drained postoperatively ; (the drain group DG) and those who had their wounds closed without drain ; (the non drain group NG).RESULTS:Seroma occurred in three patients (3%) in the DG, and in two patients (4.4%) in the NG. Small haematoma occurred in three patients (3%) in the DG, and in two patients (4.4%) in the NG. Large haematoma occurred only in one patients (1%) in the DG, and it didn't occur in the NG. Wound infection occurs only in two patients (2%) in the DG, and in one patient (2.2%) in the NG. The mean of in-hospital stay was 2.07 days in the DG, and 1.06 days in the NG.CONCLUSION:The use of drain showed no effect on the prevention of wound infection , seroma , haematoma formation or the need for re-exploration, indeed the use of drain had lengthened the in hospital stay .So the Routine use of drains after thyroid surgery might be therefore not necessary, if not detrimental.


Article
Non – Exploration of the Recurrent Laryngeal Nerve in Thyroid Surgery

Author: Hussain AlwanAl-Obaidy
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2014 Volume: 6 Issue: 1 Pages: 77-80
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Goiter is a common disease in Iraq and it is more common in the North .The disease is more common in females than in males.For this reason thyroid surgery is a common procedure.Many complications occur during and after surgery such as; bleeding, hypothyroidism, and recurrent laryngeal nerve injury.The later complication, although infrequently encountered can cause a lot of suffering to the patient.Objective: The objective of our study is assessing injury to the recurrent laryngeal nerve without exploration of the nerve routinely during thyroid surgery. exploration of the nerve done for selected cases where there is increase risk to injury.Patients and method: Prospective study of 400 patients whom underwent different thyroid surgery for different thyroid diseases done by one surgeon from July 1992 to July 2012 in Baquba teaching hospital were analyzed for permanent injury to RLN , when non-exploration of the RLN is the rule.Result: from the 400 cases included in the study only 4 cases (1%) had permanent injury to the RLN, 6 cases (1.5%) had transient injury and no injury in 390 cases (97.5%).Conclusion: Exploration of the RLN is not necessarily to be done routinely during thyroid surgery. We recommend exploration of the nerve in selected thyroid diseases.

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