Parathyroid function after open thyroidectomy: A prospective randomized study for ligasure precise versus harmonic
Gianlorenzo Dionigi1, Sam Van Slycke, Stefano Rausei
1Department of Surgical Sciences, University of Insubria, Varese-Como, Italy. gianlorenzo.dionigi@uninsubria.it
Background:
Options for controlling hemostasis during thyroidectomy include bipolar vessel sealing system and ultrasonic technology. The purpose of this study was to compare these energy-based devices on the performance of open thyroidectomy for benign disease with emphasis given to postoperative parathyroid function.
Methods:
Among the available energy-based devices, the LigaSure Precise (LP; Valleylab, Boulder, CO) and FOCUS Shears (FS; Ethicon Endo-Surgery, Cincinnati, OH) were evaluated. One hundred ninety-nine consecutive patients scheduled for open thyroidectomy were prospectively randomized into 2 similar-sized groups. Operative time, morbidity, incision length, postoperative pain, and hospital stay were analyzed. Postoperative hypoparathyroidism was monitored with serial determinations of intact parathyroid hormone (iPTH) and serum calcium.
Results:
Early postoperative measurement of iPTH plasma level, although within the reference range, was significantly lower in the FS group (p < .001). Oral calcium supplementation was significantly higher and prolonged in the FS group.
Conclusion:
The present study demonstrates a significant difference of the rates for postoperative parathyroid malfunction when using different energy-based devices.
