The Efficacy of Energy Based Vessel Sealer Devices During Total Thyroidectomy: A Comparative Single Institution Study

INTRODUCTION: Nowadays, LigaSure® (LS) and Harmonic Scapel® (HS) have been popularized among surgeons during thyroid operations. The comparison of this new technology with conventional ligature have been extensively studied. The aimed of this study was to discuss the results of thyroidectomies with LS or HS in the context of the literature. METHODS: Between January 2013 and October 2017, 224 patients who underwent total thyroidectomy in our department were evaluated for this study. The demographic characteristics, duration of operations, pathologic variables, duration of hospitalization and complication rates were retrospectively analyzed. RESULTS: Hundred and forty-nine patients were operated with LS and 75 patients were operated with HS. Thirty-eight patients were male, and 186 patients were female. Patients in the LS group were older than the HS group (p

Total Tiroidektomi Sırasında Enerji Bazlı Damar Mühürleme Cihazlarının Etkinliği: Karşılaştırmalı Tek Merkez Çalışması

GİRİŞ ve AMAÇ: Son yıllarda tiroid ameliyatlarında LigaSure® (LS) ve Harmonic Scapel® (HS) kullanımı cerrahlar arasında popüler hale gelmiştir. Bu yeni teknolojinin, geleneksel bağlama yöntemi ile karşılaştırılması, kapsamlı bir şekilde incelenmiştir. Bu çalışmada, bölümümüzün’de LS ve HS kullanarak yapılan tiroidektomi sonuçlarının güncel literatür eşliğinde tartışılması amaçlanmıştır. YÖNTEM ve GEREÇLER: Ocak 2013-Ekim 2017 tarihleri arasında bölümümüzde primer total tiroidektomi uygulanan 224 hastanın dosyaları bu çalışma için gözden geçirildi. Demografik özellikleri, operasyon süresi, patolojik değişkenler, hastanede yatış süresi ve komplikasyon oranları retrospektif olarak incelendi. BULGULAR: Yüz kırk dokuz hasta LS, 75 hasta ise HS kullanılarak ameliyat edildi. Otuz sekiz hasta erkek, 186 hasta kadındı. LS grubundaki hastalar HS grubundan daha yaşlıydı (p

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1. Zarebczan, B., D. Mohanty, and H. Chen, A Comparison of the LigaSure and harmonic scalpel in thyroid surgery: a single institution review. Ann Surg Oncol, 2011.18(1): p.214-8.

2. Giddings, A.E., The history of thyroidectomy. J R Soc Med, 1998. 91 Suppl 33: p. 3-6.

3. Upadhyaya, A., et al., Harmonic versus LigaSure hemostasis technique in thyroid surgery: A meta-analysis. Biomed Rep, 2016. 5(2): p. 221-7.

4. Chiang, F.Y., et al., Risk of vocal palsy after thyroidecitomy with identification of the recurrent laryngeal nerve. Kaohsiung J Med Sci, 2004. 20(9): p. 431-6.

5. Lo, C.Y., K.F. Kwok, and P.W. Yuen, A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. Arch Surg, 2000. 135(2): p. 204-7.

6. Snyder, S.K., et al., Elucidating mechanisms of recurrent laryngeal nerve injury during thyroidectomy and parathyroidectomy. J Am Coll Surg, 2008. 206(1): p. 123-30.

7. Thomusch, O., et al., Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: prospective multicenter study in Germany. World J Surg, 2000. 24(11): p. 1335- 41.

8. Zambudio, A.R., et al., Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann Surg, 2004. 240(1): p. 18-25.

9. Adler, J.T., et al., Preserving function and quality of life after thyroid and parathyroid surgery. Lancet Oncol, 2008. 9(11): p. 1069-75.

10. Sartori, P.V., et al., Ligasure versus Ultracision in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg, 2008. 393(5): p. 655-8.

11. Bliss, R.D., P.G. Gauger, and L.W. Delbridge, Surgeon's approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg, 2000. 24(8): p. 891-7.

12. Cannizzaro, M.A., et al., Comparison between Focus Harmonic scalpel and other hemostatic techniques in open thyroidectomy: A systematic review and meta-analysis. Head Neck, 2016. 38(10): p. 1571-8.

13. Siperstein, A.E., E. Berber, and E. Morkoyun, The use of the harmonic scalpel vs conventional knot tying for vessel ligation in thyroid surgery. Arch Surg, 2002. 137(2): p. 137-42.

14. Lachanas, V.A., et al., The use of Ligasure Vessel Sealing System in thyroid surgery. Otolaryngol Head Neck Surg, 2005. 132(3): p. 487- 9.

15. Musunuru, S., S. Schaefer, and H. Chen, The use of the Ligasure for hemostasis during thyroid lobectomy. Am J Surg, 2008. 195(3): p. 382-4; discussion 384-5.

16. Sandonato, L., et al., [Bipolar electrothermic coagulation (ligasure bipolar vessel sealing system) in thyroid surgery]. Chir Ital, 2003. 55(3): p. 411-5.

17. Romano, F., et al., Laparoscopic splenectomy using Ligasure. Preliminary experience. Surg Endosc, 2002. 16(11): p. 1608-11.

18. Robbins, M.L. and R.J. Ferland, Laparoscopic-assisted vaginal hysterectomy using the laparosonic coagulating shears. J Am Assoc Gynecol Laparosc, 1995. 2(3): p. 339-43.

19. Dubuc-Lissoir, J., Use of a new energybased vessel ligation device during laparoscopic gynecologic oncologic surgery. Surg Endosc, 2003. 17(3): p. 466-8.

20. Helal, M., et al., Laparoscopic nephrectomy using the harmonic scalpel. J Endourol, 1997. 11(4): p. 267-8.

21. McNally, M.M., et al., A comparison of two methods of hemostasis in thyroidectomy. Am Surg, 2009. 75(11): p. 1073-6.

22. Campagnacci, R., et al., Electrothermal bipolar vessel sealing device vs. ultrasonic coagulating shears in laparoscopic colectomies: a comparative study. Surg Endosc, 2007. 21(9): p. 1526-31.

23. Pons, Y., et al., Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg, 2009. 141(4): p. 496- 501.

24. Targarona, E.M., et al., Energy sources for laparoscopic colectomy: a prospective randomized comparison of conventional electrosurgery, bipolar computer-controlled electrosurgery and ultrasonic dissection. Operative outcome and costs analysis. Surg Innov, 2005. 12(4): p. 339-44.