Sutureless thyroidectomy for controlled toxic goiter: a single-institute experience | ||||
| The Egyptian Journal of Surgery | ||||
| Article 11, Volume 36, Issue 1, January 2017 PDF (414.55 K) | ||||
| DOI: 10.4103/1110-1121.199893 | ||||
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| Authors | ||||
| Ahmed Shaaban; Rabie Ramadan | ||||
| Abstract | ||||
| Background Total thyroidectomy for controlled toxic goiter is usually associated with more bleeding because of high vascularity of the toxic gland. Several new instruments were developed as hemostatic tools (harmonic scalpel; LigaSure) during total thyroidectomy as an alternative to conventional hemostatic methods. This study aimed to compare the use of Harmonic Focus Scalpel to conventional hemostatic technique (classic suture ligation with standard bipolar diathermy forceps) in patients with controlled toxic goiter undergoing total thyroidectomy regarding operative time, intraoperative complications, postoperative complications, postoperative hospital stay, and return to normal daily activities. Patients and methods The present study included 50 patients with a diagnosis of controlled toxic goiter who underwent total thyroidectomy at the Department of Surgery, Medical Research Institute Hospital, Alexandria University. Candidates were randomized into two groups: group A, in which patients underwent total thyroidectomy using Harmonic Focus Scalpel, and group B, in which patients underwent total thyroidectomy using classic suture ligation and standard reusable bipolar diathermy. Results There was no significant difference between both groups regarding preoperative data (age, sex, comorbidities, and type of thyrotoxicosis). The operative time was significantly shorter in group A patients compared with group B patients (<0.001). Both groups were comparable to each other with regard to intraoperative blood loss, postoperative transient and permanent vocal cord paresis, transient and permanent hypocalcemia, postoperative hematomas and bleeding requiring surgery, hospital stay, timing of drain removal, and return to normal daily activities. Conclusion Harmonic Focus Scalpel can be used safely and effectively as a hemostatic tool instead of conventional hemostatic techniques in total thyroidectomy for controlled toxic goiter. | ||||
| Keywords | ||||
| Harmonic Scalpel; hypocalcemia; sutureless thyroidectomy; Toxic Goiter; vocal cord paresis | ||||
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