Abstract
BACKGROUND:
Effective vessel hemostasis can be achieved by knot tying or newer techniques like ligasure as an alternative bipolar surgical diathermy system. Various diathermy techniques have been proposed to reduce intraoperative blood loss in surgery and the new electrothermal bipolar tissue sealing system (Ligasure) has been applied in various specialties of surgery.
OBJECTIVE:
To compare the outcome of ligasure versus conventional suture ligation in thyroid surgery.
METHODS:
This study was conducted in Al–Imamein Alkadhmein Medical City over 2 years period from the first of October 2016 to the first of October 2018.A Total of 110 patients were operated upon by the same surgical Team, using ligasure in 55 and conventional suture ligation in 55 patients for hemostasis. The medical records of the patients enrolled were reviewed and compared regarding age, sex, histopathological diagnosis, types of thyroidectomy, operating time, estimated intraoperative blood loss, postoperative complications, hospital stay , postoperative pain and outcome evaluation.
RESULTS:
There was no statistical difference between the two groups regarding age, sex and histopathological Data. The mean operating time was significantly shorter in the Ligasure group compared with the conventional group. Transient hoarseness of voice was detected in 2 patients (3.6%) of both groups. no permanent complication was seen in LVSS group but EBSLN injury (1.8%) was the only permanent complication occurred in conventional group.
CONCLUSION:
The use of LigaSure Vessel Sealing System for thyroid surgery is proved safe and effective as conventional suture ligation Technique, with the benefit of reducing intraoperative blood loss, reduced operating time, and postoperative pain severity.
10. Cipolla C, Graceffa G, Sandonato L, Fricano S, Vieni S, Latteri MA. LigaSure in total thyroidectomy. Surg Today. 2008;38:495–8. Cipolla C, Graceffa G, Sandonato L, Fricano S, Vieni S, Latteri MA. LigaSure in total thyroidectomy. Surg Today. 2008;38:495–98.
11. Saiura A, Yamamoto J, Koga R, Sakamoto Y, Kokudo N, Seki M, Yamaguchi T, Yamaguchi T, Muto T, Makuuchi M: Usefulness of LigaSure for liver resection: analysis by randomized clinical trial. Am J Surg 2006;192:41-45.
12. Clark OH. Total throidectomy. The treatment of choice for patients with different thyroid cancer: Ann Surg 1982;196:361-70.
13. anatomical landmark for detecting both the recurrent laryngeal nerve and the superior parathyroid during thyroid surgery,” Endocrine Journal, 2008;55: 925– 30.
14. Sukprasert M, Choktanasiri W, Ayudhya NI, Promsonthi P, O-Prasertsawat P.Increase accuracy of visual estimation of blood loss from education programme. J Med Assoc Thai. 2006 ;89 Suppl 4:S54-9.
15. . Shen WT, Baumbusch MA, Kebebew E, Duh QY. Use of the electrothermal vessel sealing system versus standard vessel ligation in thyroidectomy. Asian J Surg 2005;28:86–9.
16. Kiriakopoulosa, Dimitrios T, DimitriosL: Use of adiathermy system in thyroidsurgery.ArchSurg2004;139:997–1000.
17. Musholt TJ. [Total thyroidectomy for multinodular goiter]Chirurg. 2010; 81:603-6, 608-611
18. Wael Al Juraibi et al.: Use of Ligasure Sealing Versus Conventional Suture - Ligation in Total Thyroidectomy, Journal of Surgery 2016; 4: 34-38.
20. T.vaasna, Use of Ligasure Sealing Versus Conventional LigationinTotalThyroidectomy,Scandinavian journal of surgery 96:31-34,2007.
21. Andreas K, Tskayannis D, Linos D. Use of a diathermy system in thyroid surgery. Arch Surg 2004;139:997–1000.
22. Vassilios AL, Emmanuel PP, Antonois AM, et al. The use of LigaSure vessel sealing system in thyroid surgery. Otolaryng Head Neck Surg 2005;132:487–9.
23. Ioannis E.petraki, Use of Ligasure Sealing versus Conventional Suture- Ligation in Thyroidectomy. wileyperiodicals, inc.headneck2004:26:903-909.
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