Parathyroid function after open thyroidectomy: A prospective randomized study for ligasure precise versus harmonic FOCUS

Head Neck. 2013 Apr;35(4):562-7. doi: 10.1002/hed.23005. Epub 2012 Jun 19.

Abstract

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical
  • Calcium / blood
  • Female
  • Hemostasis, Surgical / instrumentation*
  • Humans
  • Hypoparathyroidism / epidemiology
  • Hypoparathyroidism / etiology*
  • Ligation / instrumentation
  • Male
  • Middle Aged
  • Parathyroid Glands / surgery*
  • Parathyroid Hormone / blood*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Prospective Studies
  • Thyroidectomy / instrumentation*
  • Treatment Outcome
  • Young Adult

Substances

  • Parathyroid Hormone
  • Calcium