Thyroid surgery outcome benefits with energy based devices over conventional technique: A comparative study

Abstract

Background: Thyroidectomy is the most commonly performed surgery worldwide for both benign and malignant lesions of thyroid. New surgical technologies have been introduced in thyroid surgery to achieve vessel sealing and hemostasis with an added advantage over conventional method. Aim: The primary aim of study was to compare the surgical outcome benefits of harmonic focus, LigaSure vessel sealer with conventional techniques of clamp and suture in thyroid surgeries. Objectives: The objectives of this study were to compare the three methods in terms of the overall time difference, the total blood loss in thyroid surgery, postoperative drainage output, and surgical complications. Methodology: The prospective study was conducted in Government Medical College, Anantnag, Kashmir, between 2020 June and May 2022, over a period of 2 years by the Department of ENT and HNS. A total of 84 patients who underwent thyroid surgeries (total/hemithyroidectomy) were divided into three groups: Group H (n = 28), Group L (n = 28), and Group C (n = 28). The patients were divided according to age, preoperative diagnosis (benign and malignant), and thyroid nodule size and stage of thyroid lesion to generate homogeneous groups. All cases were operated by the same surgeon to prevent surgical bias. Results: The three groups were homogeneous in terms of age, gender, clinical status, and pathology. In Group H and Group L, the mean operative time was 25–30 min shorter than Group C (P < 0.001). In Group H and Group L, the blood loss was significantly less as compared to Group C (P < 0.001). The comparison of pain score, postoperative drainage, complication rates as well as mean hospital stay was similar between the three groups (P = Statistically non significant). Conclusion: The use of surgical devices is as safe and effective for vessel dissection and hemostasis likewise conventional clamp suture technique. A significant reduction of the operative time and intraoperative blood loss was found with harmonic focus and LigaSure method compared to conventional method with comparable differences in postoperative complications, pain score, and drainage in all the three groups.