DOI: https://doi.org/10.36347/sjams.2026.v14i05.036

Pages: 854-861

Background: The routine use of suction drains following thyroid surgery remains controversial despite widespread clinical adoption. While drain placement aims to prevent hematoma formation, emerging evidence suggests minimal clinical benefit with increased patient morbidity. This study evaluated comparative outcomes of thyroidectomy performed with and without drain placement in a tertiary care setting in Bangladesh. Methods: A prospective randomized controlled trial was conducted at SHER-E-BANGLA Medical College Hospital, Barishal from January 2024 to December 2024. A total of 120 patients undergoing thyroid surgery were randomly allocated to either drain group (n=60) or no-drain group (n=60). Primary outcomes measured were postoperative pain intensity using Visual Analogue Scale (VAS) at 6, 24, and 48 hours, and length of hospital stay. Secondary outcomes included postoperative complications (hematoma, seroma, infection, hemorrhage) and cosmetic satisfaction at 4-week follow-up. Statistical analysis was performed using Independent t-test, Chi-square test, and Fisher's exact test with significance level set at p<0.05. Results: Postoperative pain was significantly lower in the no-drain group at 6 hours (2.92±0.84 vs 5.87±1.18, p<0.001), 24 hours (0.98±0.92 vs 3.68±1.15, p<0.001), and 48 hours (0.17±0.39 vs 1.43±0.88, p<0.001). Mean hospital stay was significantly shorter in the no-drain group (2.08±0.41 days vs 3.92±1.22 days, p<0.001). Postoperative complications showed no significant difference between groups (p=0.156). Cosmetic satisfaction at 4 weeks was superior in the no-drain group (91.7% satisfied vs 68.3%, p<0.001) due to absence of drain exit scar. Conclusion: Thyroidectomy without drain placement results in significantly reduced postoperative pain, shorter hospitalization, and superior cosmetic outcomes without increasing postoperative complication rates. Routine drain placement following uncomplicated thyroid surgery should be reconsidered in clinical pra