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Article: Does using an energized device in open thyroidectomy reduce complications?

TitleDoes using an energized device in open thyroidectomy reduce complications?
Authors
KeywordsElectrocautery
Postoperative hypoparathyroidism
Recurrent laryngeal nerve injury
Surgical outcome
Thyroidectomy
Issue Date2013
PublisherElsevier Inc.. The Journal's web site is located at http://www.elsevier.com/locate/jsre
Citation
Journal of Surgical Research, 2013, v. 181 n. 1, p. E23-E29 How to Cite?
AbstractBACKGROUND: Although using energy devices during open thyroidectomy might shorten the procedure time compared with the conventional technique, its effect on procedure-related complications remains unclear and controversial. In an era of cost containment, we aimed to compare the rate of procedure-related complications (particularly vocal cord palsy and hypoparathyroidism) between patients who underwent thyroidectomy using reusable ultrasonic shears and those who did not. METHODS: Of 508 eligible patients, 237 (46.7%) underwent thyroidectomy using the SonoSurg (reusable ultrasonic shears; SonoSurg group) and 271 (53.3%) underwent thyroidectomy using the conventional technique (suture ligation and clips; conventional technique group). The reusable shears were autoclaved at the end of each procedure and replaced after every 20 cases. To evaluate the effect of the ultrasonic shears on procedure-related complications, the patient characteristics and outcomes were compared between the 2 groups. RESULTS: In the SonoSurg group, the total operating time (60 min versus 105 min, P < 0.001) and temporary (12.4% versus 25.5%, P = 0.009) and permanent hypoparathyroidism (1.9% versus 9.8%, P = 0.003) rates were significantly less than those in the conventional technique group. The permanent vocal cord palsy rate was similar (P = 0.262). On multivariate analysis, using the reusable shears (odds ratio 0.163; 95% confidence interval 0.047-0.570; P = 0.005) and parathyroid autotransplantation of at least 1 gland (odds ratio 0.370; 95% confidence interval 0.146-0.943; P = 0.037) were the 2 independent variables for permanent hypoparathyroidism after completion/total thyroidectomy. CONCLUSIONS: Using the reusable shears during open thyroidectomy was significantly associated with a shortened operating time and lower permanent hypoparathyroidism rate, although the vocal cord palsy rate remained similar.
Persistent Identifierhttp://hdl.handle.net/10722/159930
ISSN
2015 Impact Factor: 2.198
2015 SCImago Journal Rankings: 0.928
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, BHHen_US
dc.contributor.authorYip, PCLen_US
dc.contributor.authorHung, GKYen_US
dc.date.accessioned2012-08-16T05:59:37Z-
dc.date.available2012-08-16T05:59:37Z-
dc.date.issued2013en_US
dc.identifier.citationJournal of Surgical Research, 2013, v. 181 n. 1, p. E23-E29en_US
dc.identifier.issn0022-4804-
dc.identifier.urihttp://hdl.handle.net/10722/159930-
dc.description.abstractBACKGROUND: Although using energy devices during open thyroidectomy might shorten the procedure time compared with the conventional technique, its effect on procedure-related complications remains unclear and controversial. In an era of cost containment, we aimed to compare the rate of procedure-related complications (particularly vocal cord palsy and hypoparathyroidism) between patients who underwent thyroidectomy using reusable ultrasonic shears and those who did not. METHODS: Of 508 eligible patients, 237 (46.7%) underwent thyroidectomy using the SonoSurg (reusable ultrasonic shears; SonoSurg group) and 271 (53.3%) underwent thyroidectomy using the conventional technique (suture ligation and clips; conventional technique group). The reusable shears were autoclaved at the end of each procedure and replaced after every 20 cases. To evaluate the effect of the ultrasonic shears on procedure-related complications, the patient characteristics and outcomes were compared between the 2 groups. RESULTS: In the SonoSurg group, the total operating time (60 min versus 105 min, P < 0.001) and temporary (12.4% versus 25.5%, P = 0.009) and permanent hypoparathyroidism (1.9% versus 9.8%, P = 0.003) rates were significantly less than those in the conventional technique group. The permanent vocal cord palsy rate was similar (P = 0.262). On multivariate analysis, using the reusable shears (odds ratio 0.163; 95% confidence interval 0.047-0.570; P = 0.005) and parathyroid autotransplantation of at least 1 gland (odds ratio 0.370; 95% confidence interval 0.146-0.943; P = 0.037) were the 2 independent variables for permanent hypoparathyroidism after completion/total thyroidectomy. CONCLUSIONS: Using the reusable shears during open thyroidectomy was significantly associated with a shortened operating time and lower permanent hypoparathyroidism rate, although the vocal cord palsy rate remained similar.-
dc.languageengen_US
dc.publisherElsevier Inc.. The Journal's web site is located at http://www.elsevier.com/locate/jsre-
dc.relation.ispartofJournal of Surgical Researchen_US
dc.subjectElectrocautery-
dc.subjectPostoperative hypoparathyroidism-
dc.subjectRecurrent laryngeal nerve injury-
dc.subjectSurgical outcome-
dc.subjectThyroidectomy-
dc.titleDoes using an energized device in open thyroidectomy reduce complications?en_US
dc.typeArticleen_US
dc.identifier.emailLang, BHH: blang@hkucc.hku.hken_US
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jss.2012.06.012-
dc.identifier.pmid22748595-
dc.identifier.scopuseid_2-s2.0-84884211558-
dc.identifier.hkuros203640en_US
dc.identifier.isiWOS:000316788400004-
dc.publisher.placeUnited States-

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