Impact of drainless neck dissection on surgical outcome: a matched case–control study

Purpose: The safety of drainless lateral neck dissection (ND) remains to be proven. Hereby, we describe outcomes of drainless ND using fibrin sealant (FS). Methods: A retrospective, single academic institute, matched cased control. The study group included patients who underwent drainless ND (drainless group), matched to control patients by age, sex, body mass index, laterality and median number of levels dissected. Additional comparison of patients who underwent at least II–IV lateral ND for a thyroid cancer indication was also conducted. Outcomes were post-operative seroma\infections. Results: A total of 118 patients (42 cases and 76 controls) were included in the study. Groups did not differ in pre-operative characteristics, percentage of bilateral ND, and extension of ND. No significant difference was found in terms of post-operative infections, seroma, aspirations, and post-operative antibiotic use. The additional analysis included 23 drainless lateral ND and matched controls, of which 91% underwent concomitant level V dissection. No significant difference was found in terms of post-operative seroma or infection. These findings were confirmed with a multivariate analysis. Conclusions: Drainless ND using FS in non-violating mucosa surgeries appears to be feasible and safe, without significantly increasing post-operative seroma and its associated complications.