The American Journal of Surgery
Volume 199, Issue 4 , Pages 485-490, April 2010

Surgical drains can be safely avoided in lateral neck dissections for papillary thyroid cancer

  • Michal Mekel, M.D.

      Affiliations

    • Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    • ,
  • Antonia E. Stephen, M.D.

      Affiliations

    • Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    • ,
  • Randall D. Gaz, M.D.

      Affiliations

    • Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    • ,
  • Gregory W. Randolph, M.D.

      Affiliations

    • Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    • Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
    • ,
  • Sara Richer, M.D.

      Affiliations

    • Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
    • ,
  • Zvi H. Perry, M.D.

      Affiliations

    • Tufts Medical Center, Boston, MA, USA
    • ,
  • Carrie C. Lubitz, M.D.

      Affiliations

    • Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    • ,
  • Matthew A. Nehs, M.D.

      Affiliations

    • Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    • ,
  • Sareh Parangi, M.D.

      Affiliations

    • Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    • ,
  • Richard A. Hodin, M.D.

      Affiliations

    • Endocrine Surgery Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
    • Corresponding Author InformationCorresponding author: Tel.: +1-617-724-2570; fax: +1-617-724-2570.

Received 17 March 2009; received in revised form 15 April 2009

Abstract 

Background

Drains are widely used in lateral neck dissections (LNDs). Our objective was to compare outcomes of LNDs for papillary thyroid cancer (PTC) with and without drains.

Methods

One hundred sixty-five LNDs in 129 patients operated on from July 2001 to October 2008 were analyzed retrospectively. LNDs were divided according to the number of excised lymph nodes as follows: group A < median and group B > median. Further categorization was based on the use of a drain. Main outcome measures were wound complications requiring intervention.

Results

One hundred two LNDs were performed with a drain and 63 without. The overall rate of wound complications was 3%. There was no significant difference in complication rate between the drain and the non-drain group (group A: 1.8% vs 0; group B: 2.2% vs 7.9%, respectively).

Conclusions

Significant seromas/hematomas are rare complications of LNDs. Patients who undergo LND for PTC without a drain show no significantly increased rate of these complications.

Keywords: Thyroid cancer, Papillary, Neck dissection, Drain

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 Dr. Mekel is a recipient of fellowship grant from the American Physicians Fellowship for Medicine in Israel. Dr. Mekel is also supported in part by Rambam-Health Care Campus, Israel, the American Friends of Rambam, Israel Medical Association and the Israel Cancer Association.

PII: S0002-9610(09)00303-1

doi:10.1016/j.amjsurg.2009.04.006

The American Journal of Surgery
Volume 199, Issue 4 , Pages 485-490, April 2010

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