[Thyroidectomy with LigaSure versus traditional thyroidectomy: our experience]. / Tiroidectomia con LigaSure vs. tiroidectomia tradizionale. Nostra esperienza.

ABSTRACT

Over the past few decades the surgical strategy for both benign and malignant thyroid diseases has undergone several changes. In particular, total thyroidectomy today has become the routine operation for most thyroid diseases. The complications of this surgical procedure, though of multifactorial aetiopathogenesis, are often related to the efficacy of the haemostasis. Our aim in this study was to verify whether the use of the new LigaSure haemostatic system is capable of reducing the incidence of these complications as well as operative times and length of hospital stay as compared to the conventional haemostatic procedures. Twenty-five patients were randomly assigned to thyroidectomy with LigaSureTM (group A), and 25 to total thyroidectomy using the conventional haemostasis procedures (group B). Of these, 39 were women and 11 men, with a mean age +/- standard deviation of 52.26 +/- 13.57 years. In both groups the thyroidectomy was performed according to the standard total thyroidectomy surgical technique entailing the placement of two aspiration drainages at the end of the operation. As regards the assessment of operative times, these were significantly lower in thyroidectomy with LigaSureTM compared to traditional thyroidectomy (duration 60 +/- 14.8 min [range 60-105) in group A versus 92.4 +/- 27.5 min [range 70-150] in group B, p = 0.02). The total amount of fluid drained postoperatively was substantially similar in the two groups (145 +/- 80 cc in group A versus 140 +/- 64.1 cc in group B). The incidence of postoperative complications was also similar in the two groups. We had only one case of haemorrhage in a patient submitted to thyroidectomy with LigaSureTM, 8 cases of transitory hypocalcaemia, 3 of which in patients with LigaSure thyroidectomy and 5 in patients treated with traditional thyroidectomy (p = 0.42), 2 cases of stupor of the recurrent nerve (1 in group A and 1 in group B) and a single definitive recurrent lesion in a group B patient with carcinoma, in which the tumour infiltrated the recurrent nerve. We observed no cases of definitive hypocalcaemia. The mean postoperative hospital stay of the patients in group A was 1.88 +/- 0.44 days as against 2.2 +/- 0.41 days in group B. The statistical analysis revealed a significant difference between the two groups (p = 0.01).