[Dissection and coagulation technique in thyroid surgery - is it the key to a successful outcome?]

This study analyzes the impact of coagulation instrument devices used during thyroid gland removal in which careful dissection and perfect haemostasis represent very important aspects. Standard electrocautery is compared to the use of bipolar forceps. The aim is to determine whether the use of different modes of coagulation is the key to the frequency and severity of postoperative complications following total thyroidectomy.

This study included 82 patients undergoing total thyroidectomy with haemostasis by conventional suture ligation technique combined with monopolar electrocauterization and 36 patients undergoing total thyroidectomy with complete haemostasis by bipolar forceps. The main outcomes measured were postoperative bleeding, recurrent laryngeal nerve palsy and post-thyroidectomy hypocalcaemia and hypoparathyroidism. Patients were followed up for 6 months.

The results of our study showed that the use of bipolar forceps for vessel ligation in thyroid surgery is as safe and effective as the use of monopolar electrocautery and ligatures. Statistical analysis showed no significant differences in the rate of the individual postoperative complications between the two cohorts. Complication rates in the entire cohort were comparable with data reported in the literature.

Both approaches are safe and reliable and both represent valid options. The choice might depend on the surgeons preferences and experience, the nature of the thyroid condition and the nature and extent of the surgical procedure.