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 ,Revised 15 April 2009

References 

  1. Lewis RT, Goodall RG, Marien B, et al. Simple elective cholecystectomy: to drain or not. Am J Surg. 1990;159:241–245
  2. Tzovaras G, Liakou P, Fafoulakis F, et al. Is there a role for drain use in elective laparoscopic cholecystectomy? A controlled randomized trial. Am J Surg. 2009;197:759–763
  3. Petrowsky H, Demartines N, Rousson V, et al. Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg. 2004;240:1074–1084
  4. Belghiti J, Kabbej M, Sauvanet A, et al. Drainage after elective hepatic resection (A randomized trial). Ann Surg. 1993;218:748–753
  5. Merad F, Hay JM, Fingerhut A, et al. Is prophylactic pelvic drainage useful after elective rectal or anal anastomosis? A Multicenter Controlled Randomized Trial (French Association for Surgical Research). Surgery. 1999;125:529–535
  6. Kim J, Lee J, Hyung WJ, et al. Gastric cancer surgery without drains: a prospective randomized trial. J Gastrointest Surg. 2004;8:727–732
  7. Monson JR, Guillou PJ, Keane FB, et al. Cholecystectomy is safer without drainage: the results of a prospective, randomized clinical trial. Surgery. 1991;109:740–746
  8. Talbot ML, Magarey CJ. Reduced use of drains following axillary lymphadenectomy for breast cancer. ANZ J Surg. 2002;72:488–490
  9. Baas-Vrancken Peeters MJ, Kluit AB, Merkus JW, et al. Short versus long-term postoperative drainage of the axilla after axillary lymph node dissection (A prospective randomized study). Breast Cancer Res Treat. 2005;93:271–275
  10. Jeffrey SS, Goodson WH, Ikeda DM, et al. Axillary lymphadenectomy for breast cancer without axillary drainage. Arch Surg. 1995;130:909–912
  11. Ariyanayagam DC, Naraynsingh V, Busby D, et al. Thyroid surgery without drainage: 15 years of clinical experience. J R Coll Surg Edinb. 1993;38:69–70
  12. Khanna J, Mohil RSChintamani, et al. Is the routine drainage after surgery for thyroid necessary? A prospective randomized clinical study [ISRCTN63623153]. BMC Surg. 2005;5:11
  13. Shaha AR, Jaffe BM. Selective use of drains in thyroid surgery. J Surg Oncol. 1993;52:241–243
  14. Schoretsanitis G, Melissas J, Sanidas E, et al. Does draining the neck affect morbidity following thyroid surgery?. Am Surg. 1998;64:778–780
  15. Shaha AR. Complications of neck dissection for thyroid cancer. Ann Surg Oncol. 2008;15:397–399
  16. Uchino S, Noguchi S, Yamashita H, et al. Modified radical neck dissection for differentiated thyroid cancer: operative technique. World J Surg. 2004;28:1199–1203
  17. Lombardi CP, Raffaelli M, Princi P, et al. Minimally invasive video-assisted functional lateral neck dissection for metastatic papillary thyroid carcinoma. Am J Surg. 2007;193:114–118
  18. Elboim CM, Goldman L, Hann L, et al. Significance of post-cholecystectomy subhepatic fluid collections. Ann Surg. 1983;198:137–141
  19. Cheah WK, Arici C, Ituarte PH, et al. Complications of neck dissection for thyroid cancer. World J Surg. 2002;26:1013–1016
  20. Burkey SH, van Heerden JA, Thompson GB, et al. Reexploration for symptomatic hematomas after cervical exploration. Surgery. 2001;130:914–920
  21. Bergamaschi R, Becouarn G, Ronceray J, et al. Morbidity of thyroid surgery. Am J Surg. 1998;176:71–75
  22. Debry C, Renou G, Fingerhut A. Drainage after thyroid surgery: a prospective randomized study. J Laryngol Otol. 1999;113:49–51
  23. Roh JL, Kim DH, Park CI. Prospective identification of chyle leakage in patients undergoing lateral neck dissection for metastatic thyroid cancer. Ann Surg Oncol. 2008;15:424–429
  24. Gregor RT. Management of chyle fistulization in association with neck dissection. Otolaryngol Head Neck Surg. 2000;122:434–439
  25. Lee SW, Choi EC, Lee YM, et al. Is lack of placement of drains after thyroidectomy with central neck dissection safe? A prospective, randomized study. Laryngoscope. 2006;116:1632–1635
  26. Robbins KT, Clayman G, Levine PA, et al. Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg. 2002;128:751–758
  27. Agrama MT, Reiter D, Topham AK, et al. Node counts in neck dissection: are they useful in outcomes research?. Otolaryngol Head Neck Surg. 2001;124:433–435
  28. Friedman M, Lim JW, Dickey W, et al. Quantification of lymph nodes in selective neck dissection. Laryngoscope. 1999;109:368–370

 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