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能量器械免打结甲状腺切除术:切拉哈萨经验。

Sutureless thyroidectomy with energy-based devices: Cerrahpasa experience.

机构信息

Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University, Fatih/Istanbul, 34098, Turkey,

出版信息

Updates Surg. 2013 Dec;65(4):301-7. doi: 10.1007/s13304-013-0231-2. Epub 2013 Aug 29.

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.

摘要

甲状腺全切除术占所有甲状腺切除术的大多数。近年来为控制血管蒂而开发的基于能量的先进血管封闭装置在甲状腺手术中取得了显著进展。本研究旨在比较两种基于能量的血管封闭装置(Ligasure™ LF1212 和 Harmonic FOCUS(®))在无缝线甲状腺切除术中的效率和安全性。245 例连续患者接受了无缝线甲状腺全切除术。患者随机分为 Ligasure™ LF1212 组(n = 126)或 Harmonic FOCUS(®) 组(n = 119)。记录了人口统计学、手术适应证、发病率、切口长度、手术持续时间、标本重量、引流量、术后疼痛、住院时间和标本组织病理学的参数。手术时间的平均值为 37.98 ± 14.98 分钟(16-92 分钟),Harmonic FOCUS(®) 组明显缩短(p < 0.001)。平均住院时间为 1.09 ± 0.3 天(1-3 天)。总发病率为 9.8%,无死亡病例。就发病率而言,两组之间无显著差异(p = 0.476)。在两组中,除术后常规应用外,均无需额外应用镇痛药物。根据我们的经验,无缝线甲状腺切除术可以以安全有效的方式进行,且发病率低。

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