Efficacy of fibrin glue after thyroidectomy: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

GUO Qiong ¹ , CHENG Rui ² , LENG Fangqun ³ , ZHANG Chenyang ³ , CHEN Xuan ² , LONG Youlin ¹ , HE Mingdong ² , ZHANG Wen ² ,  DU Liang ^1,4 ,  HUANG Jin ⁵

1. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. West China School of Medicine, Sichuan University, Chengdu 610041, P.R.China;
3. West China School of Public Health, Sichuan University, Chengdu 610041, P.R.China;
4. West China Medical Publishers, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
5. West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

DU Liang, Email: duliang0606@vip.sina.com; HUANG Jin, Email: michael.huangjin@gmail.com

Keywords：

Thyroid gland; Thyroidectomy; Fibrin tissue adhesive; Systematic review; Meta-analysis; Randomized controlled trials

DOI：

10.7507/1672-2531.201911136

Video：

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Objective To systematically review efficacy application of fibrin glue (FG) after thyroidectomy.Methods PubMed, EMbase, The Cochrane Library, ClinicalTrials.gov, CBM, CNKI, WanFang Data and VIP databases were searched to collect randomized controlled trials (RCTs) regarding the use of FG after thyroidectomy from inception to October 29^th, 2019. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.Results A total of 15 RCTs involving 2 406 patients were included. The results of meta-analysis showed that compared with non-FG group, the use of FG could reduce postoperative drainage amount at the initial 24 hours (MD=−17.98, 95%CI −28.35 to −7.60, P=0.000 7), total amount of wound drainage (MD=−40.92, 95%CI −46.25 to −35.59, P<0.000 01), and postoperative discomfort (RR=0.48, 95%CI 0.35 to 0.66, P<0.000 01), as well as shorten drainage time (MD=−9.99, 95%CI −15.74 to −4.23, P=0.000 7) and stitches removal time (MD=−1.49, 95%CI −2.1 to −0.87, P<0.000 01). However, there was no statistically significant difference concerning postoperative short-term complications such as swelling (RR=0.78, 95%CI 0.48 to 1.28, P=0.32), recurrent laryngeal nerve injury (RR=0.83, 95%CI 0.21 to 3.29, P=0.79) and wound infection (RR=0.28, 95%CI 0.07 to 1.21, P=0.09) between two groups.Conclusions The current evidence shows that FG can reduce postoperative drainage amount and shorten postoperative recovery time in thyroidectomy. Due to the limited quality and quantity of included studies, more high quality studies are required to verify above conclusions.

Citation： GUO Qiong, CHENG Rui, LENG Fangqun, ZHANG Chenyang, CHEN Xuan, LONG Youlin, HE Mingdong, ZHANG Wen, DU Liang, HUANG Jin. Efficacy of fibrin glue after thyroidectomy: a systematic review. Chinese Journal of Evidence-Based Medicine, 2020, 20(7): 789-797. doi: 10.7507/1672-2531.201911136 Copy

1.	刘首记, 王湛. 医用生物蛋白胶应用于甲状腺次全切除术的意义. 现代生物医学进展, 2007, 7(9): 1365-1366.
2.	Sözen S, Topuz O, Tükenmez M, et al. The use of fibrin sealant after total thyroidectomy for benign disease obviates the need for routine drainage. Results of a randomized controlled trial. Hippokratia, 2011, 15(3): 247-251.
3.	Terris DJ, Snyder S, Carneiro-Pla D, et al. American Thyroid Association statement on outpatient thyroidectomy. Thyroid, 2013, 23(10): 1193-1202.
4.	Cannizzaro MA, Lo Bianco S, Picardo MC, et al. How to avoid and to manage post-operative complications in thyroid surgery. Updates Surg, 2017, 69(2): 211-215.
5.	Materazzi G, Ambrosini CE, Fregoli L, et al. Prevention and management of bleeding in thyroid surgery. Gland Surg, 2017, 6(5): 510-515.
6.	Geraci G, D'Orazio B, Chiarenza S, et al. Efficacy of fibrin sealant in thyroid surgery. Is drainage still necessary? Ann Ital Chir, 2019, 90: 100-105.
7.	张焕君. 医用生物蛋白胶在甲状腺手术中的应用. 护理研究, 2008, 22(6): 562.
8.	Li L, Liu W, Tao H, et al. Efficacy and safety of negative pressure versus natural drainage after thyroid surgery: a systematic review and meta-analysis. Medicine (Baltimore), 2018, 97(31): e11576.
9.	Woods RS, Woods JF, Duignan ES, et al. Systematic review and meta-analysis of wound drains after thyroid surgery. Br J Surg, 2014, 101(5): 446-456.
10.	Smith RB, Coughlin A. Thyroidectomy hemostasis. Otolaryngol Clin North Am, 2016, 49(3): 727-748.
11.	Gao F, Ma J, Sun W, et al. Topical fibrin sealant versus intravenous tranexamic acid for reducing blood loss following total knee arthroplasty: A systematic review and meta-analysis. Int J Surg, 2016, 32: 31-37.
12.	Uwiera TC, Uwiera RR, Seikaly H, et al. Tisseel and its effects on wound drainage post-thyroidectomy: prospective, randomized, blinded, controlled study. J Otolaryngol, 2005, 34(6): 374-378.
13.	Kim TW, Choi SY, Jang MS, et al. Efficacy of fibrin sealant for drainage reduction in total thyroidectomy with bilateral central neck dissection. Otolaryngol Head Neck Surg, 2012, 147(4): 654-660.
14.	Wan X, Wang W, Liu J, et al. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol, 2014, 14: 135.
15.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration, 2011. Available from: www.handbook.cochrane.org/.
16.	宋中林. 甲状腺腺瘤摘除术不同引流方法的疗效比较. 现代诊断与治疗, 2017, 28(15): 2880-2881.
17.	王进超, 蔡胜华. 生物蛋白胶在颈部内镜甲状腺切除术中的应用及效果分析. 医学综述, 2016, 22(7): 1410-1411, 1414.
18.	李洪俊. 甲状腺瘤摘除不同引流方法的疗效比较. 中国医药指南, 2013, 11(19): 526-527.
19.	宋永蔚, 张静潭. 医用生物蛋白胶在甲状腺单侧腺叶及峡部切除术中的应用. 亚太传统医药, 2009, 5(6): 57-58.
20.	劳卫荣, 梁国健, 林建生. 纤维蛋白封闭剂在甲状腺手术中的应用. 中华全科医学, 2009, 7(5): 491-492.
21.	王景丽. 医用生物蛋白胶在甲状腺手术中的应用观察. 山东医药, 2008, 48(43): 55.
22.	王军. 医用生物蛋白胶在甲状腺癌联合根治术中的应用. 临床外科杂志, 2006, 14(5): 317-317.
23.	何兆群, 梁伟雄. 甲状腺次全切除术不放引流物的术式探讨. 中华临床医学研究杂志, 2003, (14): 11965-11966.
24.	张惠, 刘治滨. 甲状腺次全切除术两种手术方法的疗效观察. 医学研究杂志, 2008, 37(5): 76-78.
25.	张献义, 刘宁青, 吕鹏飞, 等. 医用生物蛋白胶在甲状腺手术中的应用. 中华普通外科杂志, 2004, 19(8): 511.
26.	Nguyen SA. A trial comparing wound drainage and post-operative complications with and without the use of evicel^TM fibrin sealant in thyroidectomy. 2019. Available at: https://clinicaltrials.gov/ct2/show/results/NCT01226914.
27.	Spotnitz WD. Fibrin sealant: the only approved hemostat, sealant, and adhesive-a laboratory and clinical perspective. ISRN Surg, 2014, 2014: 203943.
28.	Carless PA, Henry DA. Systematic review and meta-analysis of the use of fibrin sealant to prevent seroma formation after breast cancer surgery. Br J Surg, 2006, 93(7): 810-819.
29.	Jain R, Wairkar S. Recent developments and clinical applications of surgical glues: an overview. Int J Biol Macromol, 2019, 137: 95-106.
30.	Pryor SG, Sykes J, Tollefson TT. Efficacy of fibrin sealant (human) (Evicel) in rhinoplasty: a prospective, randomized, single-blind trial of the use of fibrin sealant in lateral osteotomy. Arch Facial Plast Surg, 2008, 10(5): 339-344.
31.	Mankad PS, Codispoti M. The role of fibrin sealants in hemostasis. Am J Surg, 2001, 182(2 Suppl): 21S-28S.
32.	Yu MS, Kang SH, Kim BH, et al. Effect of aerosolized fibrin sealant on hemostasis and wound healing after endoscopic sinus surgery: a prospective randomized study. Am J Rhinol Allergy, 2014, 28(4): 335-340.
33.	华丹, 郭子君. 医用生物蛋白胶在甲状腺手术中应用的 Meta 分析. 中国组织工程研究, 2014, 18(8): 1283-1288.
34.	郭子君, 华丹. 医用生物蛋白胶在甲状腺手术中的应用评价. 山东医药, 2014, 54(27): 80-82.

1. 刘首记, 王湛. 医用生物蛋白胶应用于甲状腺次全切除术的意义. 现代生物医学进展, 2007, 7(9): 1365-1366.
2. Sözen S, Topuz O, Tükenmez M, et al. The use of fibrin sealant after total thyroidectomy for benign disease obviates the need for routine drainage. Results of a randomized controlled trial. Hippokratia, 2011, 15(3): 247-251.
3. Terris DJ, Snyder S, Carneiro-Pla D, et al. American Thyroid Association statement on outpatient thyroidectomy. Thyroid, 2013, 23(10): 1193-1202.
4. Cannizzaro MA, Lo Bianco S, Picardo MC, et al. How to avoid and to manage post-operative complications in thyroid surgery. Updates Surg, 2017, 69(2): 211-215.
5. Materazzi G, Ambrosini CE, Fregoli L, et al. Prevention and management of bleeding in thyroid surgery. Gland Surg, 2017, 6(5): 510-515.
6. Geraci G, D'Orazio B, Chiarenza S, et al. Efficacy of fibrin sealant in thyroid surgery. Is drainage still necessary? Ann Ital Chir, 2019, 90: 100-105.
7. 张焕君. 医用生物蛋白胶在甲状腺手术中的应用. 护理研究, 2008, 22(6): 562.
8. Li L, Liu W, Tao H, et al. Efficacy and safety of negative pressure versus natural drainage after thyroid surgery: a systematic review and meta-analysis. Medicine (Baltimore), 2018, 97(31): e11576.
9. Woods RS, Woods JF, Duignan ES, et al. Systematic review and meta-analysis of wound drains after thyroid surgery. Br J Surg, 2014, 101(5): 446-456.
10. Smith RB, Coughlin A. Thyroidectomy hemostasis. Otolaryngol Clin North Am, 2016, 49(3): 727-748.
11. Gao F, Ma J, Sun W, et al. Topical fibrin sealant versus intravenous tranexamic acid for reducing blood loss following total knee arthroplasty: A systematic review and meta-analysis. Int J Surg, 2016, 32: 31-37.
12. Uwiera TC, Uwiera RR, Seikaly H, et al. Tisseel and its effects on wound drainage post-thyroidectomy: prospective, randomized, blinded, controlled study. J Otolaryngol, 2005, 34(6): 374-378.
13. Kim TW, Choi SY, Jang MS, et al. Efficacy of fibrin sealant for drainage reduction in total thyroidectomy with bilateral central neck dissection. Otolaryngol Head Neck Surg, 2012, 147(4): 654-660.
14. Wan X, Wang W, Liu J, et al. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol, 2014, 14: 135.
15. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration, 2011. Available from: www.handbook.cochrane.org/.
16. 宋中林. 甲状腺腺瘤摘除术不同引流方法的疗效比较. 现代诊断与治疗, 2017, 28(15): 2880-2881.
17. 王进超, 蔡胜华. 生物蛋白胶在颈部内镜甲状腺切除术中的应用及效果分析. 医学综述, 2016, 22(7): 1410-1411, 1414.
18. 李洪俊. 甲状腺瘤摘除不同引流方法的疗效比较. 中国医药指南, 2013, 11(19): 526-527.
19. 宋永蔚, 张静潭. 医用生物蛋白胶在甲状腺单侧腺叶及峡部切除术中的应用. 亚太传统医药, 2009, 5(6): 57-58.
20. 劳卫荣, 梁国健, 林建生. 纤维蛋白封闭剂在甲状腺手术中的应用. 中华全科医学, 2009, 7(5): 491-492.
21. 王景丽. 医用生物蛋白胶在甲状腺手术中的应用观察. 山东医药, 2008, 48(43): 55.
22. 王军. 医用生物蛋白胶在甲状腺癌联合根治术中的应用. 临床外科杂志, 2006, 14(5): 317-317.
23. 何兆群, 梁伟雄. 甲状腺次全切除术不放引流物的术式探讨. 中华临床医学研究杂志, 2003, (14): 11965-11966.
24. 张惠, 刘治滨. 甲状腺次全切除术两种手术方法的疗效观察. 医学研究杂志, 2008, 37(5): 76-78.
25. 张献义, 刘宁青, 吕鹏飞, 等. 医用生物蛋白胶在甲状腺手术中的应用. 中华普通外科杂志, 2004, 19(8): 511.
26. Nguyen SA. A trial comparing wound drainage and post-operative complications with and without the use of evicel^TM fibrin sealant in thyroidectomy. 2019. Available at: https://clinicaltrials.gov/ct2/show/results/NCT01226914.
27. Spotnitz WD. Fibrin sealant: the only approved hemostat, sealant, and adhesive-a laboratory and clinical perspective. ISRN Surg, 2014, 2014: 203943.
28. Carless PA, Henry DA. Systematic review and meta-analysis of the use of fibrin sealant to prevent seroma formation after breast cancer surgery. Br J Surg, 2006, 93(7): 810-819.
29. Jain R, Wairkar S. Recent developments and clinical applications of surgical glues: an overview. Int J Biol Macromol, 2019, 137: 95-106.
30. Pryor SG, Sykes J, Tollefson TT. Efficacy of fibrin sealant (human) (Evicel) in rhinoplasty: a prospective, randomized, single-blind trial of the use of fibrin sealant in lateral osteotomy. Arch Facial Plast Surg, 2008, 10(5): 339-344.
31. Mankad PS, Codispoti M. The role of fibrin sealants in hemostasis. Am J Surg, 2001, 182(2 Suppl): 21S-28S.
32. Yu MS, Kang SH, Kim BH, et al. Effect of aerosolized fibrin sealant on hemostasis and wound healing after endoscopic sinus surgery: a prospective randomized study. Am J Rhinol Allergy, 2014, 28(4): 335-340.
33. 华丹, 郭子君. 医用生物蛋白胶在甲状腺手术中应用的 Meta 分析. 中国组织工程研究, 2014, 18(8): 1283-1288.
34. 郭子君, 华丹. 医用生物蛋白胶在甲状腺手术中的应用评价. 山东医药, 2014, 54(27): 80-82.

Chinese Journal of Evidence-Based Medicine

Efficacy of fibrin glue after thyroidectomy: a systematic review

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