A Safety-Based Comparison of Pure LigaSure Use and LigaSure-Tie Technique in Total Thyroidectomy
A. Pergel, A. Fikret Yucel, I. Aydin, D.A. Sahin, S. Aras, H. KulacogluOriginal article, no. 1, 2014
Background and Aim: Sutureless total thyroidectomy by usingvessel sealing devices has been shown to be safe in some recentclinical studies. However, some surgeons are still concernedabout the use of these energy devices in the vicinity of therecurrent laryngeal nerve and parathyroid glands. Theobjective of this study was to investigate the effects of the useof pure LigaSure on postoperative complications and to discussthe pertinent literature.Methods: A total of 456 patients having undergone a totalthyroidectomy operation between June 2009 and March 2011 were included in the study. Data were prospectively collectedand retrospectively evaluated. Patients were separated into 2groups. Group L comprised of 182 patients where onlyLigaSure was used, and group LT consisted of 274 patientswhere ligation was used in the vicinity of the recurrentlaryngeal nerve and parathyroid glands, and LigaSure was usedin all other parts of the surgery. Patient’s blood calcium valueswere checked preoperatively and at postoperative 24, 48, and72 hours. Groups were assessed in terms of demographicproperties, thyroid pathology, duration of operation, and postoperativecomplications.Results: Groups were similar in respect of demographicproperties, operation duration, thyroid gland pathology. Nomortality rate was recorded. Laboratory hypocalcemia rate washigher in group L (P 0.003), but no significant difference wasidentified between groups in terms of symptomatic hypocalcemia.No permanent hypocalcemia or recurrent laryngealnerve injury developed in any of the patients in the twogroups.Conclusions: Pure LigaSure for total thyroidectomy mayincrease laboratory hypocalcemia rate, but not symptomatichypocalcemia. Hemorrhage related complications weresimilar and low in the two groups. Ligations in the places closeto delicate anatomic structures did not cause longer operativetimes and may be a safer option in total thyroidectomy.
