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Parathyroid function after open thyroidectomy: A prospective randomized study for ligasure precise versus harmonic FOCUS
Author(s) -
Dionigi Gianlorenzo,
Van Slycke Sam,
Rausei Stefano,
Boni Luigi,
Dionigi Renzo
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23005
Subject(s) - medicine , thyroidectomy , surgery , hemostasis , harmonic scalpel , hypoparathyroidism , parathyroid hormone , prospective cohort study , anesthesia , thyroid , calcium , blood loss
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. Conclusion The present study demonstrates a significant difference of the rates for postoperative parathyroid malfunction when using different energy‐based devices. © 2012 Wiley Periodicals, Inc. Head Neck, 2013