Predictive factors of increased surgical drain output after thyroid lobectomy: a retrospective study

Chih-Yu Chen, Yu-Lung Chiu, Sarina Rajbhandari, Sheng-Yao Cheng, Hung-Che Lin, Yueng-Hsiang Chu, Jih-Chin Lee


Background: Thyroid lobectomy is one of the most common operations for thyroid lesions. Life-threatening complications can occur; these include post-operative bleeding with airway compression caused by hematoma. Given this risk, prophylactic drains are routinely used in our practice. The aim of this study was to identify factors that influence the total drainage volume (TDV).
Methods: From 2016 to 2017, a total of 89 consecutive patients with thyroid lobectomy performed by the same surgeon were included in the study. The demographic characteristics of the patients, TDV, fine needle aspiration cytology, hospitalization day, operation time, thyroid gland size, and blood test results were retrospectively recorded from the hospital database. Spearman’s rank correlation and multivariate regression were used to analyze the association of factors with the TDV.
Results: The median TDV was 56 mL, and there was a positive correlation between age, weight, blood sugar, gland size, hospitalization day, operation time, and TDV. Multivariate regression analysis revealed that male sex (β=19.684; 95% CI, 7.998–31.371; P=0.001), higher blood sugar (β=0.173; 95% CI, 0.087–0.260; P<0.001), and larger thyroid gland size (β=0.069; 95% CI, 0.008–0.130; P=0.027) were independent risk factors for TDV.
Conclusions: The TDV primarily depends on male sex, larger thyroid gland, and higher blood sugar level. Patients with these factors should undergo meticulous hemostasis and bleeding should be carefully monitored in the perioperative period.