Bipolar cautery versus conventional suture ligation of vascular pedicles in thyroidectomy: a comparative clinical study

Abstract

Background: Thyroidectomies are commonly performed surgeries worldwide. With better knowledge of anatomy and major advent of energy devices, morbidity of thyroidectomy has drastically declined. Two main globally followed procedures to deal with vascular pedicles are conventional suture ligation and electro cautery devices. The objectives of the present study are to compare classical suture ligation and bipolar cautery of vascular pedicles in thyroidectomy, in terms of duration of procedure, hospitalization and operative complications.Methods: Retrospective observational comparative study was conducted in 100 patients who underwent total thyroidectomy in our institution for a period of 3 years from 4 September 2017. Non random sampling techniques applied on all consecutive patients who are eligible according to the inclusion criteria. Patients divided into two groups used: suture ligation (n=50), bipolar cauterization (n=50). The main outcomes measured were surgical and hospitalization time; duration of wound drain and post-operative complications (hoarseness, hypocalcemia and seroma).Student t test (for quantitative) and Chi Squaretest (for qualitative) applied for analysis.Results: Post-operative complications are present more in the suture ligation group (66%) compared to bipolar cautery (24%). The procedure time in ligation is a 131.6±17.7 minutes which is, significantly higher compared to bipolar cautery (97±7.5 minutes). Duration of hospital stay is more in suture ligation (6±0.8 days) compared to bipolar cautery (4.9±1.3 days).Conclusions: As per our study, bipolar cauterization has significant reduction of surgery time, duration of hospital stay and postoperative complications viz seroma, hoarseness of voice, hypocalcemia compared to conventional suture ligation.