Drains in Thyroid and Parathyroid Surgery: Are They Necessary?

Objective: To assess the postoperative complications in patients who underwent elective thyroid or parathyroid surgery without postoperative drainage. Design: During a 6-year period all patients who met study criteria were prospectively evaluated. Setting: General community and tertiary referral center. Patients: Fifty-seven patients undergoing thyroid surgery and eight patients undergoing parathyroid surgery were evaluated. Twenty-four patients were excluded because drains were placed postoperatively. Reasons for exclusion included presence of a large dead space, substernal goiter, extensive neck dissection for malignant neoplasm, and large goiters. Results: Major complications consisted of a hematoma requiring reexploration in one patient, and a recurrent nerve palsy in one patient. Minor complications consisted of temporary hypocalcemia (three), seroma (one), and superior flap edema that resolved in 3 months (20). Conclusion: Routine prophylactic drainage in a select patient population is unnecessary after uncomplicated thyroid or parathyroid surgery.