Parathyroid function after open thyroidectomy: A prospective randomized study for ligasure precise versus harmonic FOCUS.
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.


CONCLUSIONS
The present study demonstrates a significant difference of the rates for postoperative parathyroid malfunction when using different energy-based devices.
Department of Surgical Sciences, University of Insubria, Varese-Como, Italy. gianlorenzo.dionigi@uninsubria.it
Gianlorenzo
G
Dionigi
Sam
S
Van Slycke
Stefano
S
Rausei
Luigi
L
Boni
Renzo
R
Dionigi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002118:Calcium / Q000097:blood; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D007011:Hypoparathyroidism / Q000453:epidemiology / Q000209:etiology*; D008026:Ligation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000601:surgery*; D010281:Parathyroid Hormone / Q000097:blood*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D013965:Thyroidectomy / Q000295:instrumentation*; D016896:Treatment Outcome; D055815:Young Adult
D010281:Parathyroid Hormone; D002118:Calcium