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Harmonic Focus™ versus “knot tying” during total thyroidectomy: a randomized trial

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Abstract

The objective of the study is to compare the outcome of total thyroidectomy (TT) using the Harmonic Focus™ (HF) versus conventional “knot tying” (KT) in terms of operative time, parathyroid function and post-operative complications. This prospective study was designed with a random allocation of subjects using a drawing technique. Eighty-one consecutive patients were submitted to TT in 2010 and randomly divided into two groups: 43 patients operated using HF (HF group) and 38 patients operated using KT (KT group). Parathyroid function was evaluated by parathyroid hormone (PTH) level at 1 h postoperatively and calcium level at first post-operative day. Indications for medical therapy were PTH < 15 pg/ml and/or calcium < 8.0 mg/dl and/or clinical signs or symptoms of hypocalcemia. Main outcomes were operative time, PTH and calcium levels, need for medical therapy and post-operative complications. Mean operative time was significantly lower in HF group compared with KT group (100 ± 34 vs. 119 ± 30 min). There were no significant differences concerning transient hypoparathyroidism requiring calcium and/or vitamin D therapy: 17 patients (39.5%) in HF group versus 21 (55.3%) in KT group. Five patients (11.6%) in HF group experienced symptomatic hypocalcemia versus 6 (15.8%) in KT group, without statistically significant difference. No patients experienced recurrent nerve injury. HF is a new ergonomic, reliable device developed for thyroid surgery. According to our results, HF is a safe, time-saving alternative to “knot tying” thyroidectomy, with no influence on parathyroid function, medical therapy and nerve injury.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Chirurgia Generale, Policlinico Tor Vergata (PTV, p. 6B), University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy

    Paolo Gentileschi, Stefano D’Ugo, Edoardo Iaculli & Achille Lucio Gaspari

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  1. Paolo Gentileschi
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  2. Stefano D’Ugo
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  3. Edoardo Iaculli
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  4. Achille Lucio Gaspari
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Correspondence to Stefano D’Ugo.

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Gentileschi, P., D’Ugo, S., Iaculli, E. et al. Harmonic Focus™ versus “knot tying” during total thyroidectomy: a randomized trial. Updates Surg 63, 277–281 (2011). https://doi.org/10.1007/s13304-011-0099-y

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  • DOI: https://doi.org/10.1007/s13304-011-0099-y

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