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Thyroidectomy with ultrasonic dissector: a multicentric experience
F D'Ajello1, R Cirocchi, G Docimo
1Endocrine Surgincal Unit, University of Perugia, Italy.
Il Giornale Di Chirurgia
|July 22, 2010
Summary
Ultrasonic dissector (UAS) significantly reduces operative time and hospital costs in thyroidectomy compared to conventional technique (CT). However, UAS showed a higher incidence of transient laryngeal nerve palsy, with no difference in permanent complications.
Area of Science:
- Surgical Innovation
- Thyroid Surgery
- Clinical Trials
Background:
- Thyroidectomy is a common procedure for goitre and thyroid carcinoma.
- Evaluating new surgical techniques is crucial for improving patient outcomes and cost-effectiveness.
Purpose of the Study:
- To compare the benefits of ultrasonic dissector (UAS) versus conventional technique (CT) in thyroidectomy.
- To assess operative time, complication rates, and hospitalization duration.
Main Methods:
- A clinical controlled trial (CCT) involving 2,736 patients undergoing thyroidectomy.
- Patients were divided into two groups: UAS (1,021 patients) and CT (1,715 patients).
Main Results:
- UAS group had significantly shorter operative time (80 vs. 120 minutes).
- UAS group showed a higher incidence of transient laryngeal nerve palsy (1.6% vs. 0.9%).
- No significant differences were observed in permanent laryngeal nerve palsy, permanent hypocalcemia, or post-operative hospitalization (2 days).
Conclusions:
- Ultrasonic dissector offers cost-effectiveness due to reduced operative time and hospitalization.
- While UAS reduces operative duration, it does not improve outcomes regarding transient complications like laryngeal nerve palsy.
- Surgeon experience remains the primary factor influencing complication rates in thyroidectomy.
