Sheahan P, O'Connor A, Murphy MS. Comparison of incidence of postoperative seroma between flapless and conventional techniques for thyroidectomy: a case-control study.
Clin Otolaryngol 2012;
37:130-5. [PMID:
22336266 DOI:
10.1111/j.1749-4486.2012.02454.x]
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Abstract
OBJECTIVES
The incidence of seroma after thyroidectomy has been reported between 1.3% and 7%. We hypothesised that a flapless thyroidectomy technique would reduce the incidence of seroma.
DESIGN
Observational case-control study with comparison between retrospective cohort of patients undergoing thyroidectomy with raising of conventional skin flaps and prospective cohort undergoing flapless surgery.
SETTING
Academic Teaching Hospital.
PARTICIPANTS
Hundred and seventy-five consecutive patients undergoing thyroidectomy performed by a single surgeon. After the first 85 cases, a change in practice took place, from raising of conventional skin flaps to performing flapless surgery wherever feasible.
MAIN OUTCOME MEASURES
Occurrence of postoperative seroma, defined as central neck swelling in postoperative period, confirmed by aspiration of serous fluid, and other complications.
RESULTS
Eight patients who underwent concomitant lateral (jugular) neck dissection were excluded. Among the remaining 167 patients, there were eight seromas (5%). Following the change in practice to flapless surgery, there was a significant reduction in the incidence of seroma (P = 0.025). There was no significant difference in other complications (haematoma; recurrent laryngeal nerve injury; and hypocalcaemia). Among the entire group, the association between seroma and flapless surgery tended towards significance (P = 0.07). Other variables studied, including use of drain and concomitant central compartment neck dissection, had no effect on seroma.
CONCLUSION
Flapless technique for thyroid surgery may reduce the incidence of postoperative seroma.
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