Endocrine Abstracts

Background: Vessel hemostasis during thyroidectomy is the mainstay of reducing the risk of post-operative hypocalcaemia, which can be achieved by using several techniques. The aim of this study was to compare the occurrence of hypocalcaemia 24–48 hours following total thyroidectomy by using FOCUS harmonic scalpel (HS) vs the conventional suture ligation (CSL).

Patients and methods: A prospective, single-blind, randomized trial in which 76 patients with benign multinodular goiters scheduled to undergo total thyroidectomy, were randomized into two groups: to receive HS (n=38) or CSL (38). Patients were monitored for hypocalcaemia at 24 and 48 h post-operatively and the lengths of post-operative hospital stay. Statistical analysis to detect between-group difference was based on student’s t-test performed using SPSS.

Results: The incidence post-operative hypocalcaemia was 15.79% and 36.84%, in HS and CSL groups, respectively (P=0.033). Length of hospital stay was 2.63±0.85 and 1.37±0.67 days, respectively (P<0.001), identification of parathyroid glands was significantly associated with hypocalcaemia in the CSL group (P=0.019) but not in the HS group (P=0.372).

Conclusions: FOCUS HS is a reliable and safe technique, with the potential of achieving hemostasis in total thyroidectomy for benign thyroid disease. The conventional suture ligation technique should be replaced with FOCUS HS in thyroid surgery practice.

Keywords: Conventional hemostasis, Harmonic scalpel, suture ligation, Multinodular goiters, thyroidectomy