title: A comparison of two methods of hemostasis in thyroidectomy.
abstract: Safe thyroid surgery requires meticulous hemostasis. The objective of the current study is to compare the effectiveness and safety of ultrasonic dissection (UD) and electronic vessel sealing (EVS) in patients undergoing thyroidectomy. A retrospective analysis of a prospectively maintained database was performed. Between January 1, 2007 and January 25, 2008, hemostasis was achieved using EVS (LigaSure Precise, Valleylab, Boulder, CO). Since January 25, 2008, hemostasis has been achieved using UD (Harmonic Focus, Ethicon Endo-Surgery, Cincinnati, OH). Operative time, estimated blood loss, gland weight, and postoperative complications were compared. Differences were analyzed using unpaired t test and Chi square with significance assigned P < 0.05. Seventy-four patients underwent total thyroidectomy (EVS n = 59, UD n = 15). Operative time (EVS 115.0 +/- 38.3 min, UD 88.0 +/- 14.0 min, P = 0.012) was significantly decreased in the UD group compared with the EVS group. There were no significant differences in mean age (EVS 50.4 +/- 13.9 years, UD 49.1 +/- 15.6 years), gender distribution (EVS 78% female, UD 87% female), estimated blood loss (EVS 49.4 +/- 44.7 mL, UD 47.0 +/- 70.4 mL), and gland weight (EVS 67.4 +/- 66.4 gm, UD 41.3 +/- 26.6 gm). Analysis of complications, including hematoma, hypocalcemia, and recurrent laryngeal nerve palsy showed no significant difference. Based on the current analysis, ultrasonic dissection is a safe method of hemostasis for thyroid surgery. Its use decreases operative time when compared with electronic vessel sealing.
authors.affiliation: Department of Surgery, East Carolina University, Brody School of Medicine, Greenville, NC 27858, USA. mcnallym@ecu.edu
authors.forename: Michael M
authors.initials: MM
authors.lastname: McNally
authors.forename: Steven C
authors.initials: SC
authors.lastname: Agle
authors.forename: R Fredrick
authors.initials: RF
authors.lastname: Williams
authors.forename: Walter E
authors.initials: WE
authors.lastname: Pofahl
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000379:methods*; D014464:Ultrasonic Therapy / Q000379:methods*