在甲状腺手术中使用 Harmonic 手术刀和 LigaSure 的术后并发症比较

F. Mulita, E. Liolis, L. Tchabashvili, Konstantinos Tasios, Vasileios Papanikos, Christos Tsilivigkos, Andreas Antzoulas, G. Verras
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摘要

背景:甲状腺手术是内分泌外科领域最常见的手术。本研究旨在比较 2008 年 1 月至 2022 年 12 月期间 1599 例全甲状腺手术中 LigaSure 血管(LS)和 Harmonic 手术刀(HS)的使用情况,分析手术并发症、住院时间和手术时间。方法:在这项回顾性研究中,患者被分为两组:A组包括2008年1月至2013年5月使用LigaSure血管的718名患者,B组包括2013年6月至2022年12月使用Harmonic手术刀的881名患者。本文总结了两组患者的术后并发症病例总数、手术时间和住院时间。结果:两组患者的性别、年龄和平均手术时间无明显差异(P>0.05)。使用LS进行甲状腺切除术的患者中,分别有4人(0.6%)或14人(1.9%)发生大出血或伤口感染,而使用HS进行甲状腺手术的患者中,分别有4人(0.5%)或15人(1.7%)发生大出血或伤口感染(P>0.05,P>0.05)。此外,A组患者中有91人(12.7%)或39人(5.4%)出现甲状旁腺功能减退或暂时性喉返神经麻痹,而B组患者中有98人(11.1%)或44人(5%)出现这种情况(P> 0.05和P> 0.05)。结论 目前的研究表明,使用这两种设备可以安全地进行甲状腺切除术,而不会增加并发症的风险。
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Comparison of postoperative complications using Harmonic scalpel and LigaSure in thyroid surgery
Background: Thyroid surgery 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 1599 total thyroid surgeries between January 2008 and December of 2022, with regards of analysis of surgical complications, duration of hospital stay and operative surgical time. Methods: In this retrospective study patients have been categorized into two groups: Group A included 718 patients from January 2008 to May 2013 when LigaSure vessel was used, and the Group B included 881 patients from June 2013 to December 2022 when Harmonic scalpel was used. A summary of the total number of postoperative complications cases, surgical time and the duration of hospital stay between the two groups is presented. Results: There was no significant difference in the sex, age, and mean operating time between the two groups (P>0.05). Either major bleeding or wound infection occurred in 4 (0.6%) or 14 (1.9%) of the patients undergoing thyroidectomy when LS was used compared to 4 (0.5%) or 15 (1.7%) of the patients undergoing thyroid surgery when HS was used (P> 0.05 and P> 0.05, respectively). In addition, either hypoparathyroidism or temporary recurrent laryngeal nerve palsy was observed in 91 (12.7%) or 39 (5.4%) of the Group A patients compared with 98 (11.1%) or 44 (5%) of the Group B patients (P> 0.05 and P> 0.05, respectively). Conclusion:  The current study demonstrates that thyroidectomy can be safely performed with both devices without increasing the risk of complications.
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