Comparing postoperative complication of LigaSure Small Jaw instrument with clamp and tie method in thyroidectomy patients: A randomized controlled trial IRCT2014010516077N1

Ramouz, A. and Rasihashemi, S. Z. and Safaeiyan, A. and Hosseini, M. (2018) Comparing postoperative complication of LigaSure Small Jaw instrument with clamp and tie method in thyroidectomy patients: A randomized controlled trial IRCT2014010516077N1. World Journal of Surgical Oncology, 16 (1).

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Comparing postoperative complication of LigaSure Small Jaw instrument with clamp and tie method in thyroidectomy patients A randomized controlled trial IRCT2014010516077N1.pdf

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Abstract

Background: LigaSure® Small Jaw (LSJ) has been recently introduced as an energy-based vessel sealing device, which has provided better intraoperative and postoperative outcomes in thyroidectomies, compared to conventional technique. In the current study, we aimed to examine the efficiency of hand-sewn and LSJ thyroidectomy, based on operation time and perioperative complications. Methods: All patients with the diagnosis of multinodular goiter, thyroid cancers, retrosternal goiter and other indications for thyroid surgeries, enrolled. Of 550 patients, 261 patients randomly assigned to the conventional group (A) and 274 patients to LigaSure Small Jaw group (B). Study groups compared concerning operative time, recurrent laryngeal nerve (RLN) injury, hypocalcemia, and postoperative complications. Results: There was no significant difference regarding demographic data between groups A and B. During total thyroidectomy, intraoperative blood loss was 64.42 ± 20.72 ml and 49.64 ± 17.92 ml in groups A and B, respectively (P 0.043). Operative time was significantly lower in LSJ group compared to the conventional group in total and subtotal thyroidectomy (P 0.002; P 0.001). Three patients who underwent conventional total thyroidectomy had RLN palsy. However, there was no significant difference between techniques regarding RLN injury (P 0.134). Postoperative total and ionized serum calcium levels decreased compared to preoperative levels in both conventional and LSJ technique; however, changes in total and ionized serum calcium were more severe in patients with conventional thyroidectomy (total calcium, P < 0.0001) (ionized calcium, P 0.005). Conclusion: The LigaSure Small Jaw device decreases operative time and intraoperative bleeding compared to conventional technique. Besides, changes in total and ionized calcium levels in patients with LSJ thyroidectomy are subtle compared to HS technique. Trial registration: Registered in Iranian Registry of Clinical Trials (www.irct.com), trial registration: IRCT2014010516077N1, Registered: 23 May 2014). © 2018 The Author(s).

Item Type: Article
Additional Information: Export Date: 16 February 2020 Correspondence Address: Rasihashemi, S.Z.; Department of Cardiothoracic Surgery, Tabriz University of Medical SciencesIran; email: Zia.hashemi@yahoo.com
Uncontrolled Keywords: Conventional Hypocalcemia LigaSure® Small Jaw Recurrent laryngeal nerve Thyroidectomy calcium ion adult Article calcium blood level controlled study disease severity female goiter human intermethod comparison Iran major clinical study male middle aged operation duration postoperative complication preoperative evaluation randomized controlled trial recurrent laryngeal nerve injury retrosternal goiter single blind procedure subtotal thyroidectomy surgical technique thyroid cancer treatment indication comparative study devices hemostasis procedures prognosis suture technique thyroid disease treatment outcome Hemostasis, Surgical Humans Postoperative Complications Single-Blind Method Suture Techniques Thyroid Diseases
Subjects: WK Endocrine System
Divisions: Mashhad University of Medical Sciences
Depositing User: lib2 lib2 lib2
Date Deposited: 06 May 2020 13:47
Last Modified: 06 May 2020 13:47
URI: http://eprints.mums.ac.ir/id/eprint/17483

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