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Abstract
Purpose
The aim of this study was to compare the outcome of total thyroidectomy performed with the LigasureTM system, HarmonicTM scalpel, and the conventional clamp-and-tie technique.
Methods
Between November 2006 and July 2009, the data were retrospectively collected from 600 consecutive total thyroidectomies by one surgeon. All cases were divided into 3 groups based on the method of hemostasis: classic group patients (n=200) underwent total thyroidectomy with the conventional clamp-and-tie technique Ligasure group patients (n=200) underwent total thyroidectomy with the LigasureTM system (electrothermal bipolar vessel sealing system) and the Harmonic group patients (n=200) underwent total thyroidectomy with a HarmonicTM scalpel (ultrasonic cutting and coagulating surgical device). We compared the clinical outcomes with respect to the operative time, amount and duration of drainage, hospital stay, and post-operative complications.
Results
The three groups were similar with respect to clinical and demographic characteristics, with the exception of invasiveness. The mean operative time of the Harmonic group was significantly shorter than the other 2 groups (P ＜0.001) specifically, 75 min in the Harmonic group, 87 min in the Ligasure group, and 120 min in the classic group. The amount of drainage in the Harmonic group was greater than the other groups (P＜0.001). Similarly, the duration of drainage and hospital stay of the Harmonic group were longer than the other groups. There was no significant difference in the incidence of complications between the three groups.
References
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Table 1.
Clinical and demographic characteristics of our patients
| Classic (n=200) | Ligasure (n=200) | Harmonic (n=200) | P value | |
|---|---|---|---|---|
| Age (years) | 48.09±11.32 | 49.01±10.88 | 48.42±11.51 | 0.715* |
| Gender | 0.684† | |||
| Male | 18 (9.0%) | 21 (10.5%) | 16 (8.0%) | |
| Female | 182 (91.0%) | 179 (89.5%) | 184 (92.0%) | |
| Site of the lesion | 0.642† | |||
| Unilateral | 162 (81.0%) | 155 (77.5%) | 161 (80.5%) | |
| Bilateral | 38 (19.0%) | 45 (22.5%) | 39 (19.5%) | |
| Size of the mass (cm) | 1.00±1.07 | 1.12±1.17 | 0.98±0.62 | 0.308* |
| Cases with the invasion‡ | 30 (15.0%) | 21 (10.5%) | 118 (59.0%) | ＜0.001† |
| Diagnosis | 0.138† | |||
| Benign | 21 (10.5%) | 31 (15.5%) | 19 (9.5%) | |
| Malignancy | 179 (89.5%) | 169 (84.5%) | 181 (90.5%) | |
| Postoperative Tg level (ng/ml) | 1.04±0.85 | 0.96±0.87 | 1.01±0.83 | 0.638* |
Table 2.
Comparisons of the operation outcomes
| Classic (n=200) | Ligasure (n=200) | Harmonic (n=200) | P value | |
|---|---|---|---|---|
| Operation time (min) | 120.48±39.60 | 87.53±27.55 | 75.30±19.21 | ＜0.001* |
| Amount of drainage (ml) | 81.89±70.76 | 80.29±54.18 | 116.94±63.00 | ＜0.001* |
| Duration of drainage (day) | 2.87±1.36 | 2.99±1.90 | 4.37±1.55 | ＜0.001* |
| Hospital stay (day) | 4.73±2.06 | 5.02±2.03 | 6.90±1.65 | ＜0.001* |
| iCa (mmol/L) | 1.04±0.11 | 1.03±0.09 | 1.03±0.09 | 0.670* |
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