[Argon plasma thyroid resections--main points and advantages].

ABSTRACT

UNLABELLED Here in we present our experience with a new surgical technique of Argon Plasma Thyroid Resections which was developed in our institution to avoid the use of lots of haemostatic instruments and various size blood vessels ligations. AIM: To demonstrate the results we achieved and the advantages of APR, compared with the conventional thyroid resection. MATERIAL AND METHODS: For the period from 01. Feb. 2003 to 31. May 2004 85 patients underwent argonplasma resection (APR) of the thyroid gland in our institution. All patients were females, mean age 38, 5 years. Preoperative ultrasound examination of the thyroid has been performed in all patients for more precise determination of both thyroid lobes volume and echoic pattern of the thyroid gland. FNAB has been performed in 37 (43.5%) patients with suspicious malignancy. The distribution of patients according to the nature of the thyroid disease was as follows 12 patients with Grave's disease, 7 patients with diffuse goiter, 20 patients with nodular goiter, 28 patients with thyroid adenoma, 14 patients with Hashimoto thyroiditis and 4 patients with thyroid cancer. The procedure has been made by means of an Argon Plasma Coagulation System (Berchtold GmbH). A power setting at 20 W has been used, with time of exposition at 15 seconds and gas-flow at 2 l/h. RESULTS: Twenty one isthmusectomies with partial resection of one lobe, thirty one isthmusectomies with subtotal resection of one lobe, nine isthmusectomies with partial resection of both lobes, six isthmusectomies with partial resection of one lobe and subtotal resection of the other lobe fourteen subtotal thyroidectomies and four thyroidectomies were performed. Lack of bleeding, smooth resection line, without need for haemostatic instruments and blood vessels ligation, minimal injury on the remaining thyroid tissue as well as shortening of the operative time have been observed. CONCLUSIONS: The experience we've gained delineates the newly developed technique of APR as a safe and promissing technique in the surgical treatment of selected patients with indications for thyroid sugery.