The effect of no drainage in patients who underwent thyroidectomy with neck dissection: A systematic review and meta-analysis

BACKGROUND: To evaluate the effect of no drainage in patients who underwent thyroidectomy and neck lymph node dissection. METHODS: We followed the methodological standard expected by Cochrane. We searched the following databases by March 23, 2017: PubMed, The Cochrane Library, EMBASE via Ovid SP, and Medline via Ovid SP. Two reviewers screened the studies and extracted the data. Randomized controlled trials (RCTs) or nonrandomized interventional studies assessing the effect of no drainage following thyroidectomy with lymph node dissection were included. RESULTS: Three studies with 387 participants were included. There was no statistical difference between groups for the overall perioperative complications (2 RCTs, n = 234, RR 1.56, 95% CI 0.53–4.64), or specific complications such as seroma (2 RCTs, n = 234, RR 1.81, 95% CI 0.46–7.07), hematoma (2 RCTs, n = 234, RR 0.72, 95% CI 0.11–4.83) or hemorrhage (1 RCT, n = 69, RR 0.29, 95% CI 0.01–6.87). One case required reoperation due to hemorrhage in the drainage group was reported in 1 study (n = 32). No mortality was reported. Two studies (n = 234) stated a longer hospital stay in the drainage group than that in the group without drainage. There was moderate or serious bias for the risk of bias of included studies. CONCLUSION: The effect of no-drainage in patients with thyroid cancer who received thyroidectomy with neck dissections remains uncertain, since there are very few studies that addressed the question. Drainage may lead to longer hospital stay than nondrainage. More randomized or nonrandmized studies are required to address this issue.