title: Prospective randomized trial of ligasure versus harmonic hemostasis technique in thyroidectomy.
abstract: BACKGROUND
  Two surgical devices have become popular in thyroid surgery: a bipolar energy sealing system (B) and ultrasonic coagulation (UC). Retrospective and prospective studies have demonstrated that the use of these surgical devices for thyroidectomy compared with conventional thyroidectomy (clamp-and-tie) techniques reduces operative time and cost. We conducted a prospective randomized clinical trial to determine if there is any difference in operative time and cost between B and UC.
  
  
  METHODS
  A single-blinded prospective randomized controlled trial was conducted at a tertiary referral center. A total of 90 patients who required a thyroidectomy for thyroid cancer, thyroid nodules, or hyperthyroidism were randomized to either B or UC during thyroidectomy. The operative time and cost of thyroidectomy were compared between the two groups.
  
  
  RESULTS
  There was no statistically significant difference in patient age, gender, body mass index, indication for thyroidectomy and thyroid gland weight between the two groups. There was no statistically significant difference in operating room cost or total cost for thyroidectomy between the B and UC groups. There was also no statistically significant difference in the operative time between the B and UC groups (187.6 vs. 184.2 min, P = 0.48) or in postoperative complication rates. The only statistically significant difference in total cost was between surgeons independent of the device used (P < 0.01).
  
  
  CONCLUSIONS
  In thyroid surgery, total cost and operative time were similar between the two surgical devices used.
authors.affiliation: Endocrine Oncology Section, Surgery Branch, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Rahbari
authors.forename: Aarti
authors.initials: A
authors.lastname: Mathur
authors.forename: Mio
authors.initials: M
authors.lastname: Kitano
authors.forename: Marlon
authors.initials: M
authors.lastname: Guerrero
authors.forename: Wen T
authors.initials: WT
authors.lastname: Shen
authors.forename: Quan-Yang
authors.initials: QY
authors.lastname: Duh
authors.forename: Orlo H
authors.initials: OH
authors.lastname: Clark
authors.forename: Electron
authors.initials: E
authors.lastname: Kebebew
mesh_terms: D016063:Blood Loss, Surgical; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008026:Ligation / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome