Fa Zhang, Yan Li, Xiwei Zhang, Zhaoyang Wang, Boshizhang Peng, Mengxiao Wu, Shaoyan Liu, Dangui Yan, Zongmin Zhang, Changming An
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Participants were randomly allocated into three groups based on drainage pressure. Postoperative drainage volume, hospitalization duration, and complications were recorded. For patients undergoing total thyroidectomy, PTH and serum calcium levels were measured postoperatively. The optimal PTH cut-off value was determined using receiver operating characteristic curve analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The low-pressure group exhibited significantly reduced postoperative drainage volume on day 1 (6.54 ± 9.53 mL) compared to the medium- and high-pressure groups (34.07 ± 19.05 mL and 32.41 ± 20.72 mL). Drainage removal time (1.06 ± 0.23 days) and hospitalization duration (1.26 ± 0.47 days) were also shorter in the low-pressure group. A postoperative 2-h PTH level ≤ 6.985 pg/mL effectively predicted hypocalcemia (sensitivity 79.4%, specificity 91.0%). The combined ERAS protocol further reduced hospitalization duration and significantly lowered postoperative Visual Analog Scale scores (0.85 ± 0.75) without increasing complication rates.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Low-pressure drainage reduces postoperative drainage volume and accelerates recovery in thyroid cancer patients. A 2-h postoperative PTH level ≤ 6.985 pg/mL serves as a reliable predictor for hypocalcemia. The combined strategy of optimized drainage pressure and PTH monitoring provides a safe and effective ERAS pathway for thyroid surgery.</p>\n </section>\n </div>","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"2 3","pages":"221-230"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70024","citationCount":"0","resultStr":"{\"title\":\"Application of optimized postoperative drainage pressure combined with parathyroid function monitoring in enhanced recovery after surgery for thyroid cancer: A prospective randomized controlled study\",\"authors\":\"Fa Zhang, Yan Li, Xiwei Zhang, Zhaoyang Wang, Boshizhang Peng, Mengxiao Wu, Shaoyan Liu, Dangui Yan, Zongmin Zhang, Changming An\",\"doi\":\"10.1002/eer3.70024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Postoperative drainage management and hypocalcemia monitoring are critical factors influencing enhanced recovery after surgery (ERAS) following thyroidectomy. This study aimed to evaluate the effects of different drainage pressures on postoperative drainage volume and hospitalization duration, and to explore the predictive value of parathyroid hormone (PTH) levels for hypocalcemia. The goal was to develop a multidimensional ERAS strategy for thyroid cancer patients.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This prospective randomized controlled trial enrolled 211 patients undergoing thyroidectomy. Participants were randomly allocated into three groups based on drainage pressure. Postoperative drainage volume, hospitalization duration, and complications were recorded. For patients undergoing total thyroidectomy, PTH and serum calcium levels were measured postoperatively. 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引用次数: 0
摘要
背景：术后引流管理和低血钙监测是影响甲状腺切除术后术后恢复的关键因素。本研究旨在评价不同引流压力对术后引流量及住院时间的影响，探讨甲状旁腺激素（PTH）水平对低钙血症的预测价值。目的是为甲状腺癌患者制定一个多维的ERAS策略。方法本前瞻性随机对照试验纳入211例甲状腺切除术患者。受试者根据引流压力随机分为三组。记录术后引流量、住院时间及并发症。对于接受甲状腺全切除术的患者，术后测量甲状旁腺激素和血清钙水平。利用接收机工作特性曲线分析确定最佳PTH截止值。结果低压组术后第1天引流量（6.54±9.53 mL）明显低于中、高压组（34.07±19.05 mL和32.41±20.72 mL）。低压组拔管时间（1.06±0.23 d）和住院时间（1.26±0.47 d）较低压组短。术后2 h PTH水平≤6.985 pg/mL可有效预测低钙血症（敏感性79.4%，特异性91.0%）。联合ERAS方案进一步缩短了住院时间，显著降低了术后视觉模拟量表评分（0.85±0.75），且未增加并发症发生率。结论低压引流可减少甲状腺癌患者术后引流量，促进患者康复。术后2小时甲状旁腺激素水平≤6.985 pg/mL可作为低钙血症的可靠预测指标。优化引流压力与PTH监测相结合的策略为甲状腺手术提供了一条安全有效的ERAS通路。
Application of optimized postoperative drainage pressure combined with parathyroid function monitoring in enhanced recovery after surgery for thyroid cancer: A prospective randomized controlled study
Background
Postoperative drainage management and hypocalcemia monitoring are critical factors influencing enhanced recovery after surgery (ERAS) following thyroidectomy. This study aimed to evaluate the effects of different drainage pressures on postoperative drainage volume and hospitalization duration, and to explore the predictive value of parathyroid hormone (PTH) levels for hypocalcemia. The goal was to develop a multidimensional ERAS strategy for thyroid cancer patients.
Methods
This prospective randomized controlled trial enrolled 211 patients undergoing thyroidectomy. Participants were randomly allocated into three groups based on drainage pressure. Postoperative drainage volume, hospitalization duration, and complications were recorded. For patients undergoing total thyroidectomy, PTH and serum calcium levels were measured postoperatively. The optimal PTH cut-off value was determined using receiver operating characteristic curve analysis.
Results
The low-pressure group exhibited significantly reduced postoperative drainage volume on day 1 (6.54 ± 9.53 mL) compared to the medium- and high-pressure groups (34.07 ± 19.05 mL and 32.41 ± 20.72 mL). Drainage removal time (1.06 ± 0.23 days) and hospitalization duration (1.26 ± 0.47 days) were also shorter in the low-pressure group. A postoperative 2-h PTH level ≤ 6.985 pg/mL effectively predicted hypocalcemia (sensitivity 79.4%, specificity 91.0%). The combined ERAS protocol further reduced hospitalization duration and significantly lowered postoperative Visual Analog Scale scores (0.85 ± 0.75) without increasing complication rates.
Conclusion
Low-pressure drainage reduces postoperative drainage volume and accelerates recovery in thyroid cancer patients. A 2-h postoperative PTH level ≤ 6.985 pg/mL serves as a reliable predictor for hypocalcemia. The combined strategy of optimized drainage pressure and PTH monitoring provides a safe and effective ERAS pathway for thyroid surgery.
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