A comparative study between bipolar cuttery and conventional suture ligation for hemostasis in total thyroidectomy for benign thyroid disease

Anmar Abdulkadhum Ajaj, Ali K Shaaeli
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Abstract

Background: Over the last years many surgeons have begun to use energy based devices to perform thyroid surgery, several literatures have demonstrated the benefits of these devices over traditional techniques, they can provide a combined dissection and hemostatic effect and particularly advantageous in reduction of incision length, operative time, operative blood loss and complications. Aim of study: Compare bipolar cautery to traditional suture ligation in hemostasis during complete thyroidectomy in nerve damage, operating time, hypocalcemia, post-operative blood loss and hematoma development, and hospital stay. Patients and Method: In this study 61 patients who underwent total thyroidectomy, they were divided into two groups according to the type of hemostasis: bipolar cautery hemostasis group and conventional suture ligation hemostasis group, different diseases were included (multinodular goiter, solitary thyroid nodule), these groups were compared in regard to operative time, complications and length of hospital stay. Results: The bipolar cautery hemostasis group had a shorter operation time (67.36±9.77 min) and a lower post-operative blood loss (55.78±14.45 ml) than the conventional suture ligation group (91.09±27.37 ml). Other outcomes included post-operative hematoma formation, recurrent laryngeal nerve injury, and post-operative hypoxia. Conclusion: Using bipolar cautery device in total thyroidectomy reduced the operative time and post-operative blood loss, without any change in the incidence of recurrent laryngeal nerve injury, post-operative hypocalcemia, hematoma formation, and the length of hospital stay.
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良性甲状腺疾病全甲状腺切除术中双极刀与常规缝合结扎止血的比较研究
背景:在过去的几年里,许多外科医生已经开始使用基于能量的装置来进行甲状腺手术,一些文献已经证明了这些装置比传统技术的好处,它们可以提供联合的解剖和止血效果,特别是在减少切口长度,手术时间,手术失血和并发症方面具有优势。研究目的:比较双极烧灼与传统缝合结扎在甲状腺全切除术中对神经损伤、手术时间、低钙血症、术后出血量和血肿发展、住院时间等方面的止血效果。患者与方法:本研究将61例甲状腺全切除术患者按止血方式分为双极烧灼止血组和常规缝合结扎止血组,分别针对不同疾病(多结节性甲状腺肿、孤立性甲状腺结节),比较两组患者手术时间、并发症及住院时间。结果:双极烧灼止血组手术时间(67.36±9.77 min)短于传统缝合结扎组(91.09±27.37 ml),术后出血量(55.78±14.45 ml)少。其他结果包括术后血肿形成、喉返神经损伤和术后缺氧。结论:双极烧灼装置在甲状腺全切除术中的应用减少了手术时间和术后出血量,对喉返神经损伤发生率、术后低血钙、血肿形成及住院时间无明显影响。
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