Use of BiClamp decreased the severity of hypocalcemia after total thyroidectomy compared with LigaSure: a prospective study.
BACKGROUND
Postoperative hypocalcemia is the most common complication after thyroidectomy. New surgical devices have been propose to achieve vessel sealing and hemostasis. However, the risk of parathyroid glands damage has not been fully elucidated. This prospective study was designed to evaluate the severity of hypocalcemia after total thyroidectomy by using two different sealing devices.


METHODS
Between January 2005 and December 2006, 86 patients underwent total thyroidectomy by using BiClamp (n = 46) or LigaSure (n = 40) devices in our institution. The severity of postoperative hypocalcemia was analyzed.


RESULTS
No mortality or recurrent laryngeal nerve palsy was observed. Patients characteristics were similar in both groups. The mean operation time was significantly shorter in the BiClamp group (142 +/- 35 minutes versus 170 +/- 57 minutes, P = 0.023). Eleven patients had symptomatic hypocalcemia. Hypocalcemia (< 2 mmol/l) at postoperative day 1 was more frequent in the LigaSure group than in the BiClamp group (P = 0.034). Significantly more patients in the LigaSure group required oral calcium supplementation than in the BiClamp group (67.5% versus 34.7% respectively; P = 0.002).


CONCLUSIONS
The present prospective study suggests that total thyroidectomy can be performed safely with both surgical devices. However, BiClamp reduced the operative time and the severity of postoperative hypocalcemia.
Centre de Chirurgie Viscérale et de Transplantation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg - Université Louis Pasteur, Avenue Molière, Strasbourg Cedex 67098, France.
Elie
E
Oussoultzoglou
Fabrizio
F
Panaro
Edoardo
E
Rosso
Ion
I
Zeca
Philippe
P
Bachellier
Patrick
P
Pessaux
Daniel
D
Jaeck
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000517:prevention & control*; D008026:Ligation / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome