Thyroidectomy Outcomes: Drain vs. No Drain in Multi-nodular Goiter

Background: Thyroidectomy, particularly Near Total Thyroidectomy for Multi Nodular Goiter, is a common surgical procedure. Traditionally, suction drains are used post-operatively to prevent fluid accumulation and potential airway obstruction. However, the necessity of routine drainage is a topic of debate. Objective: This study aimed to compare the outcomes of near-total thyroidectomy in patients with multinodular goiter who received suction drains with those who did not, regarding hospital stay, hematoma formation, need for second surgical intervention, and early discharge. Methods: A prospective, randomized, controlled trial was conducted at Allama Iqbal Teaching Hospital, Dera Ghazi Khan, involving 50 patients with multinodular goiter undergoing near-total thyroidectomy. Patients were randomly assigned to either a no-drain group (Group A, n = 25) or a drain group (Group B, n = 25). Length of hospital stay was analyzed using a t-test, while hematoma, second intervention, and discharge within 48 hours were compared using a chi-square test. Results: Patients without drains had a significantly shorter mean hospital stay (1.51 days) compared to those with drains (2.31 days). A significantly higher percentage of the no-drain group (88%) were discharged within 48 hours compared to the drain group (56%). There were no significant differences in hematoma formation or the need for a second surgery. The no-drain group also showed faster wound healing (15 days vs. 21 days). Conclusion: Omitting suction drains after near-Total Thyroidectomy for Multi-Nodular Goiter patients may be beneficial, leading to shorter hospital stays, faster discharge, and quicker wound healing without increasing the risk of hematoma or the need for re-intervention. Advanced energy instruments for hemostasis may reduce the need for routine drainage.