Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Apr 24;24(1):122.
doi: 10.1186/s12893-024-02414-2.

Efficacy and safety of fibrin sealant application in patients undergoing thyroidectomy: a systematic review and meta-analysis

XiaoGang Zheng  1 , Fan Wang  2 , Yong Cheng Su  3 , Chao Yang Xu  4 , Ming Zheng Wang  5
Affiliations
Meta-Analysis

Efficacy and safety of fibrin sealant application in patients undergoing thyroidectomy: a systematic review and meta-analysis

XiaoGang Zheng et al. BMC Surg. .

Abstract

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. The primary outcomes were total volume of wound drainage, length of hospitalization, and operative time. Significant differences were observed in the 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), and surgery duration (MD: -7.60, 95% CI: -14.75 to -0.45, P = 0.04). Secondary outcomes were seroma and hypoparathyroidism development. 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.

Keywords: Fibrin sealants; Length of hospitalization; Meta-analysis; Thyroid surgery; Wound drainage.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA diagram showing the process of study selection
Fig. 2
Fig. 2
Risk of bias in the included randomized controlled trials (RCTs) on FS application in patients undergoing thyroidectomy. The Cochrane Collaboration risk-of-bias evaluation technique was used to examine the probability of bias in the seven included RCTs using seven criteria [22]. Green, low risk of bias; yellow, uncertainty; red, high risk of bias
Fig. 3
Fig. 3
Forest plot showing the effect of FS application on the total wound drainage volume. FS: fibrin sealant
Fig. 4
Fig. 4
Forest plot of the effect of FS application on operative time. FS: fibrin sealant
Fig. 5
Fig. 5
Forest plot showing the effect of FS application on length of hospital stay. FS: fibrin sealant
Fig. 6
Fig. 6
Forest plot showing the effect of FS application on seromas. FS: fibrin sealant
Fig. 7
Fig. 7
Forest plot showing the effect of FS application on hypoparathyroidism. FS: fibrin sealant
Fig. 8
Fig. 8
Subgroup analysis of hospital stay
Fig. 9
Fig. 9
Sensitivity analyses of the included studies in terms of the total wound drainage volume. The two vertical axes represent the 95% CI, and the horizontal axis represents the overall HR. In the current review, the pooled OR was represented by a hollow, round shape, and was excluded from the remaining studies. The two ends of each broken line represent the corresponding 95% CI. CI: confidence interval, HR: hazards ratio, OR: odds ratio
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Callender GG, et al. Surgery for thyroid cancer. Endocrinol Metab Clin North Am. 2014;43(2):443–58. doi: 10.1016/j.ecl.2014.02.011. - DOI - PubMed
    1. Harding J, et al. Thyroid surgery: postoperative hematoma–prevention and treatment. Langenbecks Arch Surg. 2006;391(3):169–73. doi: 10.1007/s00423-006-0028-6. - DOI - PubMed
    1. Pogson CJ, Adwani A, Ebbs SR. Seroma following breast cancer surgery. Eur J Surg Oncol. 2003;29(9):711–7. doi: 10.1016/S0748-7983(03)00096-9. - DOI - PubMed
    1. Ha EJ, Lee J. The effect of fibrin glue on the quantity of drainage after thyroidectomy: a randomized controlled pilot trial. Ann Surg Treat Res. 2022;102(4):177–84. doi: 10.4174/astr.2022.102.4.177. - DOI - PMC - PubMed
    1. Galatius H, Okholm M, Hoffmann J. Mastectomy using ultrasonic dissection: effect on seroma formation. Breast. 2003;12(5):338–41. doi: 10.1016/S0960-9776(03)00110-3. - DOI - PubMed

MeSH terms

LinkOut - more resources

-