ABSTRACT
OBJECTIVE: To identify whether there are differences in the use of drains and, if used, which would be the best for thyroid surgery. DESIGN: Prospective, longitudinal, comparative, randomized study. SETTING: General Hospital Mexico City, Mexico. PATIENTS AND METHODS: One hundred fifty patients were studied, divided into three groups: group A, without drain; group B, with a Penrose drain; and group C, with a semirigid suction drain. On the basis of the preoperative diagnosis, subtotal or total thyroidectomy or hemithyroidectomy was performed. Analyzed variables were thyroid volume (TV), transoperative bleeding (TOB), flow of postoperative drain (PD), length of hospital stay (HS), and complications, such as seromas, hematomas, and hemorrhages. Statistical Analysis. Multiple variant analysis, using Scheffe's procedure and chi2. RESULTS: Group A had an average TOB of 107 mL, HS of 2 days, and TV of 153.24 mL with two complications (seromas). Group B had an average TOB of 149.8 mL, HS of 2.6 days, TV of 175.4 mL, PD of 29.6 mL, and three complications (2 seromas and 1 hematoma). Group C had an average TOB of 161.5 mL, HS of 3.11 days, TV of 173.5 mL, PD of 25.84 mL, and two seromas. No differences existed regardless of the type of drain used between groups B and C. CONCLUSION: Statistical analysis showed that the size of the gland, diagnosis, type of surgery, transoperative bleeding, and complications are not valid arguments to leave an external drain in thyroid surgery. No advantages were found between the Penrose or the semirigid suction drains. Hospital stay was longer in patients with the suction drain. These results support the notion that the use of wound drainage cannot substitute for meticulous dissection and transoperative hemostasis.
Subject(s)
Drainage/instrumentation , Thyroid Diseases/diagnosis , Thyroid Diseases/surgery , Thyroidectomy/methods , Adult , Aged , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Multivariate Analysis , Postoperative Complications/prevention & control , Prospective Studies , Reference Values , Sensitivity and Specificity , Treatment Outcome , Wound Healing/physiologyABSTRACT
OBJECTIVE: To analyze the clinical characteristic and evolution of papillary thyroid cancer with pregnancy and know the optimal time to treatment. MATERIAL AND METHODS: Cohort analytic study with two groups: One with 6 papillary cancer and pregnancy and group 2 with 24 papillary cancer and the same age, prognostic score AMES and MACIS, treatment, time of follow up and mortality. The variables analyzed was clinical presentation, local, regional, distant recurrence, and mortality. The statistical analyzed by Chi Square and t test. RESULTS: There were no statistical differentiation between the two groups in age, prognostic score, rates of recurrence and mortality with a time of follow up for G1 83 (33 to 240) months and 88 (12 to 288) months for G2. There were differences only in clinical presentation with positive cervical nodes in 100% of patients in G1 vs. 12.5% in G2. This condition does not alter the final evolution. CONCLUSION: A pregnant patient with papillary thyroid cancer can wait the end of the pregnancy and then receive the appropriated cancer treatment.