Di Rienzo R M, Bove A, Bongarzoni G, Palone G, Corradetti L, Corbellini L
Dipartmeno di Scienze Chirurgiche, Sperimentali e Cliniche, Universitá degli Studi, G. D'Annunzio di Chieti, Generate.
G Chir. 2010 Jun-Jul;31(6-7):296-8.
The aim of this study was to compare the results obtained using an electrothermal bipolar vessel sealing system (Ligasure Precise), a harmonic curved shears (Harmonic Focus) and traditional technique in total thyroidectomy. We have enrolled 93 patients and assigned randomly to three groups of 31 pt: groups L (Ligasure Precise), F (Harmonic Focus) and C (traditional thecnique). Recorded data were demographics, preoperative serum calcium levels, operation time, length of hospital stay, weight of exported gland and pathology, postoperative calcemia at one and two days and recurrent laryngeal nerve paralysis. The three groups did not present statistically significant differences in term of age, gender and pathology classification. No postoperative haemorrhages were observed. The overall incidence of hypocalcemia was 38.9% (36 pt) and the mean days of hospitalization were 2.3 days without statistically significant differences between the three groups. Only one patient (group F) presented temporary recurrent laryngeal nerve paralysis. Mean operation time (minutes) was significantly reduced by approximately 15% in group F (62.7+/-14.1) compared with group C (72.7+/-13.6; Kruskal-Wallis test: p<0.05). Both devices resulted safe and efficient. The only advantage observed was a significant reduction operation time when using Harmonic Foscus curved shears compared to the other techniques.
本研究的目的是比较在全甲状腺切除术中使用电热双极血管闭合系统(Ligasure Precise)、谐波弧形剪(Harmonic Focus)和传统技术所获得的结果。我们招募了93名患者,并随机分为三组,每组31名患者:L组(Ligasure Precise)、F组(Harmonic Focus)和C组(传统技术)。记录的数据包括人口统计学资料、术前血清钙水平、手术时间、住院时间、切除腺体重量和病理情况、术后1天和2天的血钙水平以及喉返神经麻痹情况。三组在年龄、性别和病理分类方面无统计学显著差异。未观察到术后出血情况。低钙血症的总体发生率为38.9%(36例患者),平均住院天数为2.3天,三组之间无统计学显著差异。仅1例患者(F组)出现暂时性喉返神经麻痹。与C组(72.7±13.6;Kruskal-Wallis检验:p<0.05)相比,F组的平均手术时间(分钟)显著缩短了约15%(62.7±14.1)。两种器械均安全有效。观察到的唯一优势是与其他技术相比,使用Harmonic Foscus弧形剪时手术时间显著缩短。