![]() The triglyceride level in the drained fluid was measured at 7:00 a.m. Removal of the JP drain was permitted on the 3rd postoperative day. The primary endpoints were the 24 h drainage amount (mL/day) from the JP drain and the triglyceride level (mg/dL) in the drained fluid on the 1st and 2nd postoperative days. A Jackson-Pratt (JP) drain was placed in the thyroidectomy bed in all patients. In the treatment group, a polyglycolic acid mesh sheet additionally covered the lymph node dissection area after fibrin glue was applied, as shown in Figure 1B. Before surgical wound closure, only fibrin glue (greenplast™) was applied to the lymph node dissection area in the control group, as shown in Figure 1A. The cervical lymph nodes were dissected either prophylactically or therapeutically. Dissection of the lateral aspect of thyroid was performed with middle thyroidal vein ligation, the recurrent laryngeal nerve (RLN) was identified, and the inferior thyroidal vessel was ligated. The isthmus was cut, and thyroid upper pole dissection was performed with superior thyroidal vessel ligation. The strap muscle was divided to obtain exposure of the thyroid gland. The steps for thyroid surgery were performed as follows: Under general anesthesia, a 5–7 cm transverse skin incision and subcutaneous flap elevation were performed. All surgeries were performed by a single endocrine surgeon (JW Yi). Our study suggests that polyglycolic acid mesh sheets can be safely applied to reduce postoperative drainage amount in thyroidectomy patients who need lymph node dissection.Īfter obtaining informed consent from the patients, they were randomly assigned to two groups: treatment and control. ![]() No adverse effects were observed in the treatment groups during the postoperative 9-month follow-up. ![]() The postoperative triglyceride levels were lower in the treatment group but were not statistically significant (92.1 ± 60.1 mg/dL vs. The sum of drainage amount during the whole postoperative days (1st and 2nd days) was also significantly lower in the treatment group (142.7 ± 71.0 mL vs. The drainage amount was significantly lower in the treatment group on the 2nd postoperative day (60.9 ± 34.9 mL vs. The primary outcome was the drainage amount from the Jackson-Pratt drain, and the secondary outcome was the triglyceride level in the drained fluid on the 1st and 2nd postoperative days. A total of 161 patients were included in the treatment group, and 164 patients were included in the control group. A total of 330 patients were enrolled, of which 5 patients were excluded. The patients were randomly assigned to having only fibrin glue used in the central node dissection area (control group) or to having a polyglycolic acid mesh sheet applied after fibrin glue (treatment group). This study aims to evaluate whether a polyglycolic acid mesh sheet can reduce postoperative drainage and chyle leakage in papillary thyroid cancer surgery, and this study was designed as a prospective, open-label, randomized controlled trial in a single university hospital. A polyglycolic acid mesh sheet (Neoveil™) has been demonstrated to prevent postoperative fluid leakage in other surgeries. There are few studies that deal with reducing fluid drainage and preventing chyle leakage after thyroid surgery with central lymph node dissection. Central lymph node dissection is associated with an increased amount of fluid from the dissection area and chyle leakage due to thoracic duct injury. Surgery for PTC involves resection of the thyroid gland and central lymph node dissection. Papillary thyroid cancer (PTC) is the most common type of thyroid cancer.
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