Fibrin Sealant in Thyroidectomy

Fibrin sealant may reduce length of hospitalization and operative time among patients undergoing thyroidectomy, suggests a study published in the BMC Surgery.

Various studies have focused on the application of fibrin sealants (FS) in thyroid surgery. Utilizing a meta-analysis, this systematic review analyzed the findings of recent randomized controlled trials on the safety and efficacy of FS in patients who underwent thyroidectomy. The Cochrane Library, Web of Science, Embase, PubMed, and Medline databases were searched for relevant studies, without any language restrictions. Seven randomized controlled trials were included in the originally identified 69 studies. Overall, 652 patients received FS during thyroid surgery; their outcomes were compared with those of conventionally treated patients.

Primary Outcomes

• Total volume of wound drainage (mean deviation (MD): -29.75, 95% confidence interval (CI): -55.39 to -4.11, P = 0.02)
• Length of hospitalization (MD: -0.84, 95% CI: -1.02 to -0.66, P < 0.00001)
• Operative time (MD: -7.60, 95% CI: -14.75 to -0.45, P = 0.04)

Secondary Outcomes

The risk of hypoparathyroidism did not differ between the FS and conventional groups (I = 0%, relative risk = 1.31, P = 0.38). Analysis of “seroma formation that required invasive treatment” indicated that FS showed some benefit (I² = 8%, relative risk 0.44, P = 0.15). Heterogeneity among the different trials limited their conclusions. The meta-analysis showed that although FS use did not significantly reduce seroma or hypoparathyroidism incidence in patients after thyroidectomy, it significantly reduced the total drainage volume, length of hospitalization, and duration of surgery.

Reference

Zheng, X., Wang, F., Su, Y.C. et al. Efficacy and safety of fibrin sealant application in patients undergoing thyroidectomy: a systematic review and meta-analysis. BMC Surg 24, 122 (2024). https://doi.org/10.1186/s12893-024-02414-2