Post-operative Hypocalcaemia Following Open Thyroidectomy for Benign Multinodular Goiters Using FOCUS Harmonic Scalpel Versus Conventional Suture Ligation Technique for Hemostasis: a Prospective, Single-blind, Randomized Controlled Trial
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Purpose: Vessel hemostasis during thyroidectomy reduces the risk of post-operative hypocalcaemia and is achieved using several techniques. The aim of this study was to compare the occurrence of hypocalcaemia 24-48 hours following total thyroidectomy using FOCUS harmonic scalpel (HS) versus conventional suture ligation (CSL). Methods: A prospective, single-blind, randomized trial in which 76 patients with benign multinodular goiters were randomized into two groups to receive total thyroidectomy using HS (n=38) or CSL (n=38) techniques. Patients were monitored for hypocalcaemia at 24 and 48 hours post- thyroidectomy and their length of postoperative hospital stay was recorded. Statistical analysis was performed using Student's t-test using SPSS to detect significant differences between groups. Results: The incidence of post-operative hypocalcaemia was 15.79% in the HS group, and 36.84%, in the CSL group (p =0.033). The number of in situ parathyroid glands was significantly associated with hypocalcaemia in the CSL group (P=0.019), but not in the HS group (P=0.372). Length of hospital stay was 2.63±0.85 in the CSL group and 1.37±0.67 days in the HS group (P<0.001). Conclusion: Compared to conventional hemostasis, FOCUS HS reduces the overall risk of hypocalcaemia during thyroidectomy for benign thyroid disease. The conventional suture ligation technique should be replaced with FOCUS HS technique for thyroidectomy.
Abstract
Purpose: Vessel hemostasis during thyroidectomy reduces the risk of post-operative hypocalcaemia and is achieved using several techniques. The aim of this study was to compare the occurrence of hypocalcaemia 24-48 hours following total thyroidectomy using FOCUS harmonic scalpel (HS) versus conventional suture ligation (CSL). Methods: A prospective, single-blind, randomized trial in which 76 patients with benign multinodular goiters were randomized into two groups to receive total thyroidectomy using HS (n=38) or CSL (n=38) techniques. Patients were monitored for hypocalcaemia at 24 and 48 hours post- thyroidectomy and their length of postoperative hospital stay was recorded. Statistical analysis was performed using Student's t-test using SPSS to detect significant differences between groups. Results: The incidence of post-operative hypocalcaemia was 15.79% in the HS group, and 36.84%, in the CSL group (p =0.033). The number of in situ parathyroid glands was significantly associated with hypocalcaemia in the CSL group (P=0.019), but not in the HS group (P=0.372). Length of hospital stay was 2.63±0.85 in the CSL group and 1.37±0.67 days in the HS group (P<0.001). Conclusion: Compared to conventional hemostasis, FOCUS HS reduces the overall risk of hypocalcaemia during thyroidectomy for benign thyroid disease. The conventional suture ligation technique should be replaced with FOCUS HS technique for thyroidectomy.
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