Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy
Background: Thyroid surgery has undergone many changes during the past 2 decades, including the introduction of new surgical techniques such as endoscopic or video-assisted approaches, anesthesia care, intraoperative nerve monitoring and new hemostatic tools Objectives: to assess the efficacy and sa...
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| Format: | Article |
| Language: | English |
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College of Medicine University of Baghdad
2016-10-01
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| Series: | مجلة كلية الطب |
| Subjects: | |
| Online Access: | http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/257 |
| _version_ | 1797368125105111040 |
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| author | Adil K. Saloom Mohammed Q. AbdulJabbar |
| author_facet | Adil K. Saloom Mohammed Q. AbdulJabbar |
| author_sort | Adil K. Saloom |
| collection | DOAJ |
| description | Background: Thyroid surgery has undergone many changes during the past 2 decades, including the introduction of new surgical techniques such as endoscopic or video-assisted approaches, anesthesia care, intraoperative nerve monitoring and new hemostatic tools
Objectives: to assess the efficacy and safety of Harmonic Focus shears in total thyroidectomy compared with conventional surgical technique.
Patients and methods: prospective study conducted from October 2011 till January 2016, two handers and nine patients with benign and malignant thyroid diseases, scheduled for total thyroidectomy in a governor and private hospitals were enrolled randomly into 2 groups, group A consists of 105 patient who undergone a total thyroidectomy using a harmonic FOCUSTM , and group B consists of 104 patients who underwent total thyroidectomy with conventional surgical technique.
Results: Eleven patients had papillary thyroid carcinoma: 6 (5.7%) of them in group A and 5(4.8%) in group B. Eighty seven (82.9%) patients in group A had non toxic MNG, and 12(11.4%) patients had toxic MNG, 90 (86.5%) patients in group B had non toxic MNG while the other 9 (8.7%) had toxic MNG. Mean operative time was significantly lower in group A compared to Group B (100+/- 34 vs. 119+/- 30mins, respectively). In group A mean calcium level at first post-operative day was 8.36 +/- 0.54 mg/dl. In group B mean value was 8.12+/- 0.56 mg/dl. This difference was not statistically significant. There were no significant difference between the two groups concerning transient hypocalcemia requiring calcium and Vitamin D therapy: 11(10.5%) patients in group A versus 12(11.5%) in group B. No permanent hypocalcemia was found in both groups. Two patients had transient vocal cord palsy in group A(1.9%) versus 3 patients in group B (2.8%)
Conclusions: The HF is a reliable, comfortable and safe instrument alternative to knot tying technique, very suitable hand-piece for total thyroidectomy. It creates a clean, bloodless surgical field, and there is an advantage for the surgeon to use a single tool for both dissection and hemostasis. Moreover, the HF is a time-saving option, allowing for a significant reduction of operative time, without affecting parathyroid function, need for medical therapy, and hemostasis in the early post-operative period. |
| first_indexed | 2024-03-08T17:28:03Z |
| format | Article |
| id | doaj.art-cf3377c575c24edb8d6830b60ae43f36 |
| institution | Directory Open Access Journal |
| issn | 0041-9419 2410-8057 |
| language | English |
| last_indexed | 2024-03-08T17:28:03Z |
| publishDate | 2016-10-01 |
| publisher | College of Medicine University of Baghdad |
| record_format | Article |
| series | مجلة كلية الطب |
| spelling | doaj.art-cf3377c575c24edb8d6830b60ae43f362024-01-02T17:59:16ZengCollege of Medicine University of Baghdadمجلة كلية الطب0041-94192410-80572016-10-0158310.32007/med.1936/jfacmedbagdad.v58i3.9Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomyAdil K. Saloom0Mohammed Q. AbdulJabbar1Baghdad Teaching Hospital.Baghdad Teaching Hospital.Background: Thyroid surgery has undergone many changes during the past 2 decades, including the introduction of new surgical techniques such as endoscopic or video-assisted approaches, anesthesia care, intraoperative nerve monitoring and new hemostatic tools Objectives: to assess the efficacy and safety of Harmonic Focus shears in total thyroidectomy compared with conventional surgical technique. Patients and methods: prospective study conducted from October 2011 till January 2016, two handers and nine patients with benign and malignant thyroid diseases, scheduled for total thyroidectomy in a governor and private hospitals were enrolled randomly into 2 groups, group A consists of 105 patient who undergone a total thyroidectomy using a harmonic FOCUSTM , and group B consists of 104 patients who underwent total thyroidectomy with conventional surgical technique. Results: Eleven patients had papillary thyroid carcinoma: 6 (5.7%) of them in group A and 5(4.8%) in group B. Eighty seven (82.9%) patients in group A had non toxic MNG, and 12(11.4%) patients had toxic MNG, 90 (86.5%) patients in group B had non toxic MNG while the other 9 (8.7%) had toxic MNG. Mean operative time was significantly lower in group A compared to Group B (100+/- 34 vs. 119+/- 30mins, respectively). In group A mean calcium level at first post-operative day was 8.36 +/- 0.54 mg/dl. In group B mean value was 8.12+/- 0.56 mg/dl. This difference was not statistically significant. There were no significant difference between the two groups concerning transient hypocalcemia requiring calcium and Vitamin D therapy: 11(10.5%) patients in group A versus 12(11.5%) in group B. No permanent hypocalcemia was found in both groups. Two patients had transient vocal cord palsy in group A(1.9%) versus 3 patients in group B (2.8%) Conclusions: The HF is a reliable, comfortable and safe instrument alternative to knot tying technique, very suitable hand-piece for total thyroidectomy. It creates a clean, bloodless surgical field, and there is an advantage for the surgeon to use a single tool for both dissection and hemostasis. Moreover, the HF is a time-saving option, allowing for a significant reduction of operative time, without affecting parathyroid function, need for medical therapy, and hemostasis in the early post-operative period.http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/257Harmonic Focus, Total thyroidectomy, hypocalcemia, operative time, recurrent laryngeal nerve injury. |
| spellingShingle | Adil K. Saloom Mohammed Q. AbdulJabbar Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy مجلة كلية الطب Harmonic Focus, Total thyroidectomy, hypocalcemia, operative time, recurrent laryngeal nerve injury. |
| title | Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy |
| title_full | Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy |
| title_fullStr | Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy |
| title_full_unstemmed | Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy |
| title_short | Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy |
| title_sort | comparative study between harmonic focustm to clamp and tie technique for total thyroidectomy |
| topic | Harmonic Focus, Total thyroidectomy, hypocalcemia, operative time, recurrent laryngeal nerve injury. |
| url | http://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/257 |
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