Canu Gian Luigi, Medas Fabio, Podda Francesco, Tatti Alberto, Pisano Giuseppe, Erdas Enrico, Calò Pietro Giorgio
Department of Surgical Sciences, University of Cagliari, "Policlinico Universitario Duilio Casula", Monserrato, Italy.
Gland Surg. 2020 Jun;9(3):721-726. doi: 10.21037/gs.2020.03.31.
Being the thyroid gland a highly vascularized organ, achieving a meticulous hemostasis is essential to avoid serious complications. Currently, energy-based devices are widely used in thyroid surgery. The aim of this study was to compare Harmonic Focus (HF), LigaSure Small Jaw (LSJ) and Thunderbeat Open Fine Jaw (TB) in terms of surgical outcomes and complications.
Patients undergoing thyroidectomy in our Unit between January 2012 and June 2018 were retrospectively analyzed. According to the type of energy-device used, patients were divided into three groups: Group A (HF), Group B (LSJ) and Group C (TB).
A total of 1,165 patients were included in this study: 1,012 in Group A, 96 in Group B and 57 in Group C. Demographic data and histopathological findings were comparable between the three groups. About the postoperative stay and complications, no statistically significant difference was found. The mean operative time was 89.41±20.60 minutes in Group A, 85.57±15.91 minutes in Group B and 78.07±17.67 minutes in Group C (P<0.01). However, the post-hoc test for all pairwise comparisons showed a statistically significant difference only between Group A and Group C.
HF, LSJ and TB have proved to be safe and effective. The postoperative stay and complications were comparable between the three groups. Considering the limits of our investigation, further studies are needed to investigate the effect of TB on operative times.
由于甲状腺是一个血管高度丰富的器官,实现精确止血对于避免严重并发症至关重要。目前,基于能量的设备在甲状腺手术中广泛应用。本研究的目的是比较谐波聚焦(HF)、结扎速小型颌骨(LSJ)和雷霆节拍开放式精细颌骨(TB)在手术结果和并发症方面的差异。
回顾性分析2012年1月至2018年6月在我院接受甲状腺切除术的患者。根据所使用的能量设备类型,将患者分为三组:A组(HF)、B组(LSJ)和C组(TB)。
本研究共纳入1165例患者:A组1012例,B组96例,C组57例。三组患者的人口统计学数据和组织病理学结果具有可比性。关于术后住院时间和并发症,未发现统计学上的显著差异。A组平均手术时间为89.41±20.60分钟,B组为85.57±15.91分钟,C组为78.07±17.67分钟(P<0.01)。然而,所有两两比较的事后检验显示,仅A组和C组之间存在统计学上的显著差异。
HF、LSJ和TB已被证明是安全有效的。三组患者的术后住院时间和并发症相当。考虑到我们研究的局限性,需要进一步研究来探讨TB对手术时间的影响。