Mulita Francesk, Theofanis George, Verras Georgios-Ioannis, Liolis Elias, Papanikos Vasileios, Tchabashvili Levan, Tasios Konstantinos, Iliopoulos Fotios, Tsilivigkos Christos, Kehagias Dimitrios, Kaplanis Charalampos, Antzoulas Andreas, Samaras Angelos, Drakos Nikolas, Panagiotopoulos Ioannis, Leivaditis Vasileios, Filis Dimitrios, Maroulis Ioannis, Bouchagier Konstantinos, Michalaki Marina
Department of General Surgery, University General Hospital of Patras, Greece.
Department of Oncology, University General Hospital of Patras, Greece.
Med Glas (Zenica). 2023 Aug 1;20(2). doi: 10.17392/1629-23.
Aim Thyroidectomy is the most common operation in the field of endocrine surgery. The aim of this study was to compare the use of LigaSure vessel (LS) and harmonic scalpel (HS) in 1653 total thyroidectomies between January 2008 and March of 2023, with regards to analysis of surgical bleeding complications duration the hospital stay and operative surgical time. Methods It is a retrospective analysis of a prospectively maintained database. Patients have been categorized into two groups: Group A included 718 patients from January 2008 to May 2013 when LS was used, and the Group B included 935 patients from June 2013 to March 2023 when HS was used. Results From the total of 14 postoperative bleeding cases that occurred in patients of Group A, only in 4 of them it was necessary to have a reoperation. The other 10 cases involved minor haemorrhages, while from the total of 6 postoperative bleeding cases that happened to patients of Group B, there were 4 cases that needed a reoperation (p-value >0.05) and 2 patients with minor haemorrhages. The postoperative evaluation of minor bleedings revealed statistically significant differences between the two groups (p-value < 0.05). The average hospital stay was similar in the two groups. Conclusion Both devices exhibit identical safety profiles in thyroidectomies specifically regarding major bleeding complications that require reoperation. Additionally, HS was found to be more effective at achieving haemostasis, especially in the subgroup of patients with thyroid carcinoma. The results of the present study may be useful for high-volume centres performing numerous thyroidectomies every day.
目的 甲状腺切除术是内分泌外科领域最常见的手术。本研究的目的是比较2008年1月至2023年3月期间1653例全甲状腺切除术中使用血管闭合系统(LS)和谐波刀(HS)的情况,分析手术出血并发症、住院时间和手术时长。方法 这是一项对前瞻性维护数据库的回顾性分析。患者被分为两组:A组包括2008年1月至2013年5月使用LS的718例患者,B组包括2013年6月至2023年3月使用HS的935例患者。结果 A组患者共发生14例术后出血,其中仅4例需要再次手术,另外10例为少量出血;B组患者共发生6例术后出血,其中4例需要再次手术(p值>0.05),2例为少量出血。两组少量出血的术后评估显示出统计学差异(p值<0.05)。两组的平均住院时间相似。结论 在甲状腺切除术中,特别是对于需要再次手术的大出血并发症,两种器械的安全性相同。此外,发现HS在实现止血方面更有效,尤其是在甲状腺癌患者亚组中。本研究结果可能对每天进行大量甲状腺切除术的大型中心有用。