Abstract
Total thyroidectomy makes up the majority of all thyroidectomy cases. Energy-based advanced vessel-sealing devices which were developed in recent years for the control of vascular pedicles allowed significant progress in thyroid surgery. This study is designed to compare the efficiency and safety of the two energy-based vessel-sealing devices (Ligasure™ LF1212 and Harmonic FOCUS®) in sutureless thyroidectomy. Two hundred and forty-five consecutive patients underwent sutureless total thyroidectomy. Patients were randomized for the Ligasure™ LF1212 (n = 126) or Harmonic FOCUS® (n = 119). The parameters of demographics, surgical indications, morbidity, incision length, duration of operation, weight of specimen, amount of drainage, postoperative pain, hospital stay, and histopathology of specimen were recorded. Mean duration of operation was 37.98 ± 14.98 min (16–92 min) and was significantly shorter for Harmonic FOCUS® (p < 0.001). Mean hospital stay was 1.09 ± 0.3 (1–3) days. Morbidity rate was 9.8 % in total, whereas no mortality was observed. In terms of morbidity rates, no significant difference was determined between the two groups (p = 0.476). In both groups, there was no need for extra analgesic application other than the routine given after surgery. According to our experience, sutureless thyroidectomy can be performed with low morbidity rates in secure and efficient way.
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References
Miccoli P, Materazzi G, Miccoli M, Frustaci G, Fosso A, Berti P (2010) Evaluation of a new ultrasonic device in thyroid surgery: comparative randomized study. Am J Surg 199(6):736–740. doi:10.1016/j.amjsurg.2009.04.003
Chang LY, O’Neill C, Suliburk J, Sidhu S, Delbridge L, Sywak M (2011) Sutureless total thyroidectomy: a safe and cost-effective alternative. ANZ J Surg 81(7–8):510–514
Lombardi CP, Raffaelli M, Cicchetti A, Marchetti M, De Crea C, Di Bidino R, Oragano L, Bellantone R (2008) The use of “harmonic scalpel” versus “knot tying” for conventional “open” thyroidectomy: results of a prospective randomized study. Langenbeck’s archives of surgery/Deutsche Gesellschaft fur Chirurgie 393(5):627–631. doi:10.1007/s00423-008-0380-9
Manouras A, Markogiannakis H, Koutras AS, Antonakis PT, Drimousis P, Lagoudianakis EE, Kekis P, Genetzakis M, Koutsoumanis K, Bramis I (2008) Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation. Am J Surg 195(1):48–52. doi:10.1016/j.amjsurg.2007.01.037
Youssef T, Mahdy T, Farid M, Latif AA (2008) Thyroid surgery: use of the LigaSure Vessel Sealing System versus conventional knot tying. Int J Surg 6(4):323–327. doi:10.1016/j.ijsu.2008.05.005
Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA, Udelsman R (1998) The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg 228(3):320–330
Dionigi G, Boni L, Rausei S, Frattini F, Ferrari CC, Mangano A, Leotta A, Franchin M (2012) The safety of energy-based devices in open thyroidectomy: a prospective, randomised study comparing the LigaSure (LF1212) and the Harmonic(R) FOCUS. Langenbeck’s archives of surgery/Deutsche Gesellschaft fur Chirurgie 397(5):817–823. doi:10.1007/s00423-011-0898-0
Rahbari R, Mathur A, Kitano M, Guerrero M, Shen WT, Duh QY, Clark OH, Kebebew E (2011) Prospective randomized trial of ligasure versus harmonic hemostasis technique in thyroidectomy. Ann Surg Oncol 18(4):1023–1027. doi:10.1245/s10434-010-1251-5
Sartori PV, De Fina S, Colombo G, Pugliese F, Romano F, Cesana G, Uggeri F (2008) Ligasure versus Ultracision in thyroid surgery: a prospective randomized study. Langenbeck’s archives of surgery/Deutsche Gesellschaft fur Chirurgie 393(5):655–658. doi:10.1007/s00423-008-0386-3
Endosurgery E (2001) Ultracision Harmonic Scalpel user’s manual. Cincinnati
Valleylab C (2010) Ligasure™ Curved, Small Jaw, Open Sealer/Divider (LF1212) user’s manual. Boulder
Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi PG, Pelizzo MR, Pezzullo L (2004) Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 28(3):271–276. doi:10.1007/s00268-003-6903-1
Pons Y, Gauthier J, Ukkola-Pons E, Clement P, Roguet E, Poncet JL, Conessa C (2009) Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg: Off J Am Acad Otolaryngol Head Neck Surg 141(4):496–501. doi:10.1016/j.otohns.2009.06.745
Dionigi G, Van Slycke S, Rausei S, Boni L, Dionigi R (2013) Parathyroid function after open thyroidectomy: a prospective randomized study for ligasure precise versus harmonic FOCUS. Head Neck 35(4):562–567. doi:10.1002/hed.23005
Barbaros U, Erbil Y, Bozbora A, Deveci U, Aksakal N, Dinccag A, Ozarmagan S (2006) The use of LigaSure in patients with hyperthyroidism. Langenbeck’s archives of surgery/Deutsche Gesellschaft fur Chirurgie 391(6):575–579. doi:10.1007/s00423-006-0082-0
Franko J, Kish KJ, Pezzi CM, Pak H, Kukora JS (2006) Safely increasing the efficiency of thyroidectomy using a new bipolar electrosealing device (LigaSure) versus conventional clamp-and-tie technique. Am Surg 72(2):132–136
Kirdak T, Korun N, Ozguc H (2005) Use of ligasure in thyroidectomy procedures: results of a prospective comparative study. World J Surg 29(6):771–774. doi:10.1007/s00268-005-7788-y
Musunuru S, Schaefer S, Chen H (2008) The use of the Ligasure for hemostasis during thyroid lobectomy. Am J Surg 195(3):382–384. doi:10.1016/j.amjsurg.2007.12.009 discussion 384–385
Lachanas VA, Prokopakis EP, Mpenakis AA, Karatzanis AD, Velegrakis GA (2005) The use of Ligasure Vessel Sealing System in thyroid surgery. Otolaryngol Head Neck Surg: Off J Am Acad Otolaryngol Head Neck Surg 132(3):487–489. doi:10.1016/j.otohns.2004.09.020
Miccoli P, Berti P, Dionigi G, D’Agostino J, Orlandini C, Donatini G (2006) Randomized controlled trial of harmonic scalpel use during thyroidectomy. Arch Otolaryngol Head Neck Surg 132(10):1069–1073. doi:10.1001/archotol.132.10.1069
Dror A, Salim M, Yoseph R (2003) Sutureless thyroidectomy using electrothermal system: a new technique. J Laryngol Otol 117(3):198–201. doi:10.1258/002221503321192502
Defechereux T, Rinken F, Maweja S, Hamoir E, Meurisse M (2003) Evaluation of the ultrasonic dissector in thyroid surgery. A prospective randomised study. Acta Chir Belg 103(3):274–277
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Teksoz, S., Bukey, Y., Ozcan, M. et al. Sutureless thyroidectomy with energy-based devices: Cerrahpasa experience. Updates Surg 65, 301–307 (2013). https://doi.org/10.1007/s13304-013-0231-2
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DOI: https://doi.org/10.1007/s13304-013-0231-2